CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: University Hospitals - Elyria Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $29,255
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at University Hospitals - Elyria Medical Center is $29,255. 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 1.24x the Medicare baseline. Located in 630 East River Street, Elyria, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$29,255

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: $29,255 (124%)
Ins. Median: $29,255 (124% 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 $21,039 - $41,260 90%
Blue Cross Blue Shield $21,039 - $38,378 90%
Cigna $21,039 - $30,863 90%
Devoted Health $21,039 90%
Humana $21,039 90%
Medical Mutual Of Ohio $21,039 - $43,744 90%
Molina $21,039 90%
Primetime Health Plan $21,039 90%
Summacare $21,039 - $40,118 90%
The Health Plan $21,039 - $39,732 90%
UnitedHealthcare $21,039 90%
Wellcare By Allwell $21,039 90%
Paramount $21,670 92%
Perennial Advantage Of Ohio $22,091 94%
Valor Health Plans $22,091 94%
University Health Employee Plan (Contigo) $29,255 124%
Jp Farley $33,878 144%
Aultcare $37,183 158%
Ambetter / Centene $37,871 161%
Caresource $37,871 161%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 630 East River Street, Elyria, OH 44035
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals