CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Christ Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $21,147
Cash Discount Price: $49,915
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Christ Hospital is $21,147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49,915. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 0.90x the Medicare baseline. Located in 2139 Auburn Avenue, Cincinnati, OH.

Cash / Self-Pay

$49,915

Average discount available for prompt cash payment at this facility.

Insurance Median

$21,147

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%)

Cash / Self-Pay: $49,915 (212%)

Insurance Median: $21,147 (90%)

Cash: $49,915 (212% of Medicare)

Ins. Median: $21,147 (90% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$16,494 - $49,102	70%
Kentucky Passport/Molina [2097]	$16,494	70%
Medicaid / KanCare	$16,494	70%
Wellcare Of Kentucky [2191]	$16,494	70%
Blue Cross Blue Shield	$21,147 - $71,418	90%
Buckeye Mycare Dual [2171]	$21,147	90%
Cigna	$21,147	90%
Custom Design Benefits - True Cost [3004]	$21,147	90%
Humana	$21,147	90%
Medben [2222]	$21,147	90%
Medicare (plans)	$21,147	90%
Medigold Ppo [2204]	$21,147	90%
Meridian [2185]	$21,147	90%
Other Exchange Plan [9992]	$21,147	90%
Perennial [4200]	$21,147	90%
Poppins Health [2299]	$21,147	90%
UnitedHealthcare	$21,147 - $54,532	90%
Medical Mutual [2054]	$33,089 - $50,908	141%
Allied Benefits [2163]	$49,102	209%
First Health [2041]	$49,102	209%
Meritain Health [2224]	$49,102	209%
Life Synch [2080]	$49,915	212%
Western And Southern [2076]	$50,908	217%
Geha [2168]	$54,532	232%
Golden Rule [2161]	$54,532	232%
United Medical Resources [2104]	$54,532	232%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $49,915.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 451.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Christ Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 451.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.