CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Montefiore New Rochelle Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $26,514
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Montefiore New Rochelle Hospital is $26,514. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.13x the Medicare baseline. Located in 16 Guion Place, New Rochelle, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,514

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$23,503.93

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $23,503.93 (100%)
Insurance Median: $26,514 (113%)
Ins. Median: $26,514 (113% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $23,503.93 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Healthfirst $12,332 - $24,664 52%
Empire $24,664 105%
Fidelis $24,664 105%
Metroplus $24,664 - $32,064 105%
UnitedHealthcare $24,664 - $90,078 105%
Villagecaremax $24,664 105%
Wellcare $25,158 107%
Centerlight $25,404 108%
Emblem $25,404 - $217,648 108%
Humana $25,404 108%
Amidacare $25,898 110%
Vnsny Choice $25,898 110%
Hamaspik $27,131 115%
Partners_Health_Plan $27,131 115%
Molina Healthcare Of Ny Affinity $34,037 145%
Oscar $87,612 373%
Mvp $92,981 396%
Cigna $95,320 406%
Aetna $105,510 - $118,023 449%
Centivo $136,053 579%
Northwell $148,486 632%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16 Guion Place, New Rochelle, NY 10802
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals