CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Mercy Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $23,083
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Mercy Medical Center is $23,083. 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 0.98x the Medicare baseline. Located in 1320 Mercy Drive Nw, Canton, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$23,083

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: $23,083 (98%)
Ins. Median: $23,083 (98% 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
The Health Plan $3,451 - $18,886 15%
Aetna $20,985 - $72,686 89%
Blue Cross Blue Shield $20,985 - $34,724 89%
Humana $20,985 89%
United $20,985 - $47,796 89%
Cigna $21,614 - $47,833 92%
Communicare $22,034 94%
Mmo $22,034 - $37,010 94%
Perennial Health $22,664 96%
Zing Health $23,083 98%
Summacare $36,581 156%
Medical Benefit Corp $108,180 460%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 Mercy Drive Nw, Canton, OH 44708
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals