CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Mercy Health - Fairfield Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $29,320
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Mercy Health - Fairfield Hospital is $29,320. 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 1.25x the Medicare baseline. Located in 3000 Mack Road, Fairfield, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$29,320

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: $29,320 (125%)
Ins. Median: $29,320 (125% 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
Aetna $23,456 - $46,457 100%
Blue Cross Blue Shield $23,456 - $60,832 100%
Humana $23,456 100%
Medigold [4435] $23,456 100%
Paramount Elite [3723] $23,456 100%
UnitedHealthcare $23,456 - $61,258 100%
Devoted Health Plan [4501] $23,690 101%
Caresource Mycare Ohio [4236] $23,925 102%
Medicare (plans) $23,925 102%
Buckeye Mycare Benefits [4237] $24,629 105%
Molina Mycare Ohio [4235] $24,629 105%
Caresource [4179] $34,011 145%
Buckeye [4178] $36,357 155%
Molina Marketplace Aca [4181] $38,262 163%
Meritain Health [3068] $46,457 198%
Cigna $47,797 203%
Medical Mutual [3067] $59,297 252%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 Mack Road, Fairfield, OH 45014
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals