CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Legacy Mount Hood Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $32,258
  • 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 Legacy Mount Hood Medical Center is $32,258. 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 24800 Se Stark Street, Gresham, OR.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$32,258

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: $32,258 (137%)
Ins. Median: $32,258 (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
Kaiser $29,061 - $58,122 124%
Atrio $29,933 127%
UnitedHealthcare $29,933 - $72,422 127%
Aetna $30,514 - $88,836 130%
Blue Cross Blue Shield $30,514 - $64,987 130%
Devoted Health $30,514 130%
Humana $30,514 130%
Healthnet $30,805 131%
Careoregon $31,386 134%
Pacificsource $31,386 - $61,668 134%
Ageright $31,967 136%
Cigna $31,967 136%
Providence $31,967 136%
Moda $32,548 - $76,451 138%
Summit Health $32,548 138%
Health 2 Business $55,544 236%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 24800 Se Stark Street, Gresham, OR 97030
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals