CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: SSM Health St Anthony Hospital - Midwest

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $32,252
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.37x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at SSM Health St Anthony Hospital - Midwest is $32,252. 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 1.37x the Medicare baseline. Located in 2825 Parklawn Drive, Midwest City, OK.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$32,252

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: $32,252 (137%)
Ins. Median: $32,252 (137% 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
Blue Cross Blue Shield $23,952 - $119,240 102%
Generations $23,952 102%
Global $23,952 102%
UnitedHealthcare $23,952 - $29,568 102%
Humana $24,360 104%
Phcs $25,921 110%
Preferred Community Choice $31,138 132%
Oscar $32,168 137%
Ambetter / Centene $32,336 138%
Medica $34,783 148%
Global Health Network $34,829 148%
Healthchoice $37,560 160%
Cigna $39,159 167%
Kempton $46,707 199%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2825 Parklawn Drive, Midwest City, OK 73110
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals