CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Flushing Hospital Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $42,509
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.81x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Flushing Hospital Medical Center is $42,509. 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 1.81x the Medicare baseline. Located in 45Th Avenue and Parsons Boulevard, Flushing, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$42,509

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: $42,509 (181%)

Ins. Median: $42,509 (181% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$19,094 - $40,198	81%
Aetna	$40,198 - $49,601	171%
Beacon Health Strategies	$40,198	171%
Centerlight Healthcare	$40,198	171%
Elderplan	$40,198	171%
Empire	$40,198	171%
Fidelis	$40,198	171%
Ghi	$40,198 - $64,028	171%
Hip	$40,198 - $61,168	171%
Metroplus	$40,198 - $44,218	171%
UnitedHealthcare	$40,198 - $50,839	171%
Wellcare of Ny	$40,198	171%
Humana	$40,801 - $42,811	174%
Vns	$41,002	174%
Empire - Healthplus D	$41,404	176%
Villagecaremax	$42,208	180%
Hamaspik Choice	$44,218	188%
Senior Whole Health	$44,218	188%
Emblemhealth	$44,306	189%
Centers Plan for Healthy Living	$45,022	192%
1199 National Benefit Fund	$45,809	195%
Elderserve Health	$46,228	197%
Magnacare	$46,228	197%
Oscar	$53,909	229%
Cigna	$54,866	233%
Centivo	$57,763	246%
Create Health Plan	$82,461	351%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 451.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Flushing Hospital Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 451.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.