CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Metrohealth System

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $36,344
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Metrohealth System is $36,344. 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 1.55x the Medicare baseline. Located in 2500 Metrohealth Drive, Cleveland, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$36,344

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: $36,344 (155%)
Ins. Median: $36,344 (155% 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
Ohio Health Choice $19,382 82%
Summacare $29,802 127%
Aetna $30,941 - $54,516 132%
Blue Cross Blue Shield $34,413 - $44,696 146%
Aarp $36,344 155%
Buckeye Health Plan $36,344 - $47,611 155%
Caresource $36,344 - $50,882 155%
Cigna $36,344 - $37,789 155%
Clover $36,344 155%
Communicare $36,344 155%
Devoted Health $36,344 155%
Humana $36,344 155%
Medical Mutual $36,344 - $48,811 155%
Molina Healthcare $36,344 - $50,882 155%
Paramount $36,344 155%
UnitedHealthcare $36,344 - $47,247 155%
Valor Health $36,708 156%
Perennial Advantage $37,071 158%
Mcgregor Pace $39,979 170%
Metrohealth $45,430 193%
Clarity Health $47,247 201%
Health E Ohio $54,516 232%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2500 Metrohealth Drive, Cleveland, OH 44109
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals