CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Montefiore St Luke's Cornwall

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $26,391
  • Cash Discount Price: $33,577
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Montefiore St Luke's Cornwall is $26,391. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33,577. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.12x the Medicare baseline. Located in 70 Dubois Street, Newburgh, NY.
Cash / Self-Pay
$33,577

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,391

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%)
Cash / Self-Pay: $33,577 (143%)
Insurance Median: $26,391 (112%)
Cash: $33,577 (143% of Medicare)
Ins. Median: $26,391 (112% 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
UnitedHealthcare $24,171 - $90,781 103%
Aetna $24,418 104%
Affinity $24,664 - $26,391 105%
Blue Cross Blue Shield $24,664 105%
Cdphp $24,664 105%
Fidelis $24,664 105%
Healthfirst $24,664 105%
Hudson Valley $24,664 105%
Mediblue $24,664 105%
Oscar $24,664 - $87,612 105%
Point Comfort $24,664 105%
Centerlight $25,404 108%
Emblem $25,404 - $246,861 108%
Humana $25,404 108%
Wellcare $25,404 108%
Vnsny Choice $25,898 110%
Hamaspik $27,131 115%
Magnacare $29,007 123%
Cigna $91,895 - $102,106 391%
Centivo $145,090 617%
Northwell $146,832 625%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 70 Dubois Street, Newburgh, NY 12550
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals