CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Hillcrest Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $21,393
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Hillcrest Hospital is $21,393. 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 0.91x the Medicare baseline. Located in 6780 Mayfield Road, Mayfield Heights, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$21,393

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: $21,393 (91%)
Ins. Median: $21,393 (91% 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
Mmo $18,934 - $22,034 81%
United $19,639 - $21,393 84%
Aetna $21,393 - $72,686 91%
Blue Cross Blue Shield $21,393 - $34,724 91%
Devoted Health $21,393 91%
Humana $21,393 91%
Summacare $21,393 91%
The Health Plan $21,393 91%
UnitedHealthcare $21,393 91%
Upmc $21,393 91%
Valor $21,393 91%
Cigna $22,034 - $47,833 94%
Communicare $22,462 96%
Perennial Health $23,104 98%
Pphp $23,532 100%
Medical Benefit Corp $108,180 460%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6780 Mayfield Road, Mayfield Heights, OH 44124
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals