CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: St Catherine of Siena Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $27,239
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at St Catherine of Siena Hospital is $27,239. 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 1.16x the Medicare baseline. Located in 50 Route 25A, Smithtown, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$27,239

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: $27,239 (116%)
Ins. Median: $27,239 (116% 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 $6,454 - $9,258 27%
Blue Cross Blue Shield $26,171 - $73,009 111%
Centerlight Healthcare $26,171 111%
Aetna $26,705 - $63,374 114%
Beacon Health Options $26,705 - $37,387 114%
Beacon Health Strategies $26,705 - $37,387 114%
Centers Plan For Healthy Living $26,705 114%
Elderplan Inc. $26,705 114%
Emblem Health $26,705 - $70,602 114%
Fidelis Care New York $26,705 114%
Health Plus $26,705 114%
Healthspring $26,705 114%
Independent Health $26,705 114%
Liberty Health $26,705 114%
Longevity Health Plan $26,705 114%
Medicare (plans) $26,705 - $28,040 114%
Mvp Health Plans $26,705 - $55,641 114%
Orthonet - Uniformed Services Family Health Plan $26,705 114%
Pmc $26,705 114%
Senior Whole Health $26,705 114%
Tricare $26,705 114%
UnitedHealthcare $26,705 - $73,009 114%
Universal Healthcare $26,705 114%
Veterans Affairs $26,705 114%
Zadroga $26,705 114%
Health First $26,972 - $60,086 115%
Humana $27,239 116%
Us Family Health Plan $27,555 117%
Agewell New York $27,640 118%
Wellcare Health Plan Inc $27,773 118%
Partners Health Plan $28,040 119%
Centivo $46,404 - $55,641 197%
Local 1199 $49,398 210%
Apwu $55,641 237%
Cigna $55,641 237%
Daniel H Cook $55,641 237%
Nalc $55,641 237%
Samba $55,641 237%
Mail Handlers Benefit Plan $63,374 270%
Meritain Health $63,374 270%
Nippon Life Insurance Company Of America $63,374 270%
Salvation Army $63,374 270%
Surest $68,765 293%
American Plan Administrators $70,602 300%
Amerihealth Administrators $70,602 300%
Benefit Services $70,602 300%
Ghi Cbp Ny City Employee Alternate $70,602 300%
International Benefit Administrator $70,602 300%
Ultra Benefits Inc. $70,602 300%
Self Pay $73,009 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 50 Route 25A, Smithtown, NY 11787
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals