CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Mercy Hospital Oklahoma City, Inc

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $23,577
  • Cash Discount Price: $50,932
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Mercy Hospital Oklahoma City, Inc is $23,577. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50,932. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.00x the Medicare baseline. Located in 4300 West Memorial Road, Oklahoma City, OK.
Cash / Self-Pay
$50,932

Average discount available for prompt cash payment at this facility.

Insurance Median
$23,577

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: $50,932 (217%)
Insurance Median: $23,577 (100%)
Cash: $50,932 (217% of Medicare)
Ins. Median: $23,577 (100% 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
Cigna $3,150 - $23,577 13%
Aetna $3,365 - $49,612 14%
Humana $12,081 - $23,577 51%
Medicaid / KanCare $12,081 - $30,649 51%
Community Care Contracted [320080] $18,186 - $35,365 77%
Workers Comp [20426] $20,312 86%
Blue Cross Blue Shield $23,129 - $65,644 98%
Champva [20065] $23,129 98%
Cherokee Nation Health Serv Contracted [320066] $23,129 98%
Cross Timbers Hospice [20098] $23,129 98%
Dept Of Veteran Affairs Contracted [320106] $23,129 98%
Elara Caring Aspire Hospice Contracted [320433] $23,129 98%
Elara Caring Aspire Hospice [20433] $23,129 98%
Halo Hcr Inc Hospice Contracted [320432] $23,129 98%
Halo Hcr Inc Hospice [20432] $23,129 98%
Indian Health Service Contracted [320198] $23,129 98%
Kindful Hospice Contracted [320434] $23,129 98%
Kindful Hospice [20434] $23,129 98%
Longevity Health Plan [10477] $23,129 98%
Medicare (plans) $23,129 - $24,755 98%
Mercy Hospice Okc [20252] $23,129 98%
Provider Partners Health Plans Contracted [320450] $23,129 98%
Qual Choice Contracted [320325] $23,129 98%
Tricare $23,129 - $30,623 98%
UnitedHealthcare $23,129 - $44,137 98%
Globalhealth Contracted [320145] $23,600 100%
Medica Contracted [320239] $24,538 104%
Amg Spec Hosp Edmond [20034] $24,755 105%
Osma Health Contracted [320292] $25,965 110%
Healthsmart Accel Contracted [320183] $28,298 120%
Healthsmart Preferred Care Contracted [320184] $29,429 - $52,040 125%
Ambetter / Centene $30,649 130%
Home State Health Plan Contracted [320187] $30,649 130%
Novasys Contracted [320285] $30,649 130%
Globalhealth Contracted [320144] $34,552 147%
Health Choice Contracted [320166] $43,720 186%
United Medical Resources Contracted [320454] $44,137 188%
Kempton Contracted [320214] $52,040 221%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4300 West Memorial Road, Oklahoma City, OK 73120
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals