CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Allegheny General Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $23,800
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Allegheny General Hospital is $23,800. 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 1.01x the Medicare baseline. Located in 320 East North Avenue, Pittsburgh, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$23,800

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: $23,800 (101%)
Ins. Median: $23,800 (101% 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 $15,294 - $56,354 65%
Life Pittsburgh $22,452 96%
The Health Plan Of The Upper Ohio Valley $22,452 - $24,698 96%
UnitedHealthcare $22,452 - $24,249 96%
Aetna $23,351 - $61,308 99%
Amerihealth $23,575 100%
Geisinger $23,575 100%
Highmark Wholecare $23,800 101%
Humana $23,800 101%
Medicare (plans) $23,800 - $26,045 101%
Cigna $24,024 - $64,336 102%
Jefferson Health Plans $24,249 103%
Molina $24,473 104%
American Health Plans $24,698 105%
Martin'S Point $31,029 132%
Medical Mutual $64,336 274%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 320 East North Avenue, Pittsburgh, PA 15212
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals