CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Mount Carmel Dublin

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $42,311
Cash Discount Price: $87,527
vs. Medicare Baseline: 1.80x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Mount Carmel Dublin is $42,311. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87,527. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.80x the Medicare baseline. Located in 4105 Emerald Pkwy, Dublin, OH.

Cash / Self-Pay

$87,527

Average discount available for prompt cash payment at this facility.

Insurance Median

$42,311

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: $87,527 (372%)

Insurance Median: $42,311 (180%)

Cash: $87,527 (372% of Medicare)

Ins. Median: $42,311 (180% 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	$20,546 - $67,086	87%
Blue Cross Blue Shield	$20,546 - $71,153	87%
Custom Design Benefits	$20,546	87%
Enterprise Group Planning	$20,546	87%
Medicare (plans)	$20,546	87%
Quality Care Partners	$20,546	87%
The Health Plan	$20,546	87%
UnitedHealthcare	$20,546 - $68,061	87%
Oscar	$36,474	155%
Medical Mutual	$52,639 - $76,218	224%
Rural Carrier Health Benefit Plan	$67,086	285%
American Postal Workers Secondary	$67,615	288%
Cigna	$67,615	288%
Health Partners	$67,615	288%
Healthgram	$67,615	288%
Mvp	$67,615	288%
Priority Health	$67,615	288%
Geha	$68,061	290%
Western & Southern Financial Group	$76,218	324%

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 $87,527.
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 Mount Carmel Dublin 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.