CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Good Samaritan Hospital Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $27,693
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Good Samaritan Hospital Medical Center is $27,693. 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 1.18x the Medicare baseline. Located in 1000 Montauk Highway, West Islip, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$27,693

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: $27,693 (118%)
Ins. Median: $27,693 (118% 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
Brighton $7,286 - $10,185 31%
Apwu $19,123 81%
Centivo $19,123 - $51,181 81%
Cigna $19,123 81%
Daniel H Cook $19,123 81%
Mvp Health Plans $19,123 - $27,693 81%
Nalc $19,123 81%
Samba $19,123 81%
Blue Cross Blue Shield $27,139 - $84,257 115%
Centerlight Healthcare $27,139 115%
Us Family Health Plan $27,555 117%
Centers Plan For Healthy Living $27,693 118%
Elderplan Inc. $27,693 118%
Emblem Health $27,693 - $72,675 118%
Fidelis Care New York $27,693 118%
Healthspring $27,693 118%
Independent Health $27,693 118%
Liberty Health $27,693 118%
Longevity Health Plan $27,693 118%
Medicare (plans) $27,693 - $29,078 118%
Orthonet - Uniformed Services Family Health Plan $27,693 118%
Pmc $27,693 118%
Senior Whole Health $27,693 118%
Tricare $27,693 118%
UnitedHealthcare $27,693 - $84,257 118%
Universal Healthcare $27,693 118%
Veterans Affairs $27,693 118%
Zadroga $27,693 118%
Health First $27,970 - $62,309 119%
Humana $28,247 120%
Agewell New York $28,662 122%
Aetna $28,763 - $69,913 122%
Health Plus $28,763 122%
Wellcare Health Plan Inc $28,801 123%
Partners Health Plan $29,078 124%
Local 1199 $56,446 240%
Mail Handlers Benefit Plan $69,913 297%
Meritain Health $69,913 297%
Nippon Life Insurance Company Of America $69,913 297%
Salvation Army $69,913 297%
American Plan Administrators $72,675 309%
Amerihealth Administrators $72,675 309%
Benefit Services $72,675 309%
Ghi Cbp Ny City Employee Alternate $72,675 309%
International Benefit Administrator $72,675 309%
Ultra Benefits Inc. $72,675 309%
Surest $75,508 321%
Self Pay $84,257 358%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Montauk Highway, West Islip, NY 11795
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals