CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Saint Vincent Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $26,801
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Saint Vincent Hospital is $26,801. 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 1.14x the Medicare baseline. Located in 232 West 25Th Street, Erie, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,801

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: $26,801 (114%)
Ins. Median: $26,801 (114% 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
Highmark $15,169 - $49,450 65%
Independent Health $24,390 - $31,310 104%
Fidelis $25,048 107%
Life Pittsburgh $25,048 107%
The Health Plan Of The Upper Ohio Valley $25,048 - $27,552 107%
UnitedHealthcare $25,048 - $27,052 107%
Univera $25,048 - $46,338 107%
University Of Pittsburgh Medical Center $25,408 - $26,949 108%
Blue Cross Blue Shield $25,799 110%
Aetna $26,050 - $45,629 111%
Amerihealth $26,300 112%
Highmark Wholecare $26,551 113%
Humana $26,551 113%
Medicare (plans) $26,551 - $29,055 113%
Cigna $26,801 - $41,310 114%
Jefferson Health Plans $27,052 115%
Molina $27,302 116%
American Health Plans $27,552 117%
Martin'S Point $31,029 132%
Medical Mutual $41,310 176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 232 West 25Th Street, Erie, PA 16544
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals