CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Riddle Memorial Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $26,221
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Riddle Memorial Hospital is $26,221. 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 1.12x the Medicare baseline. Located in 1068 West Baltimore Pike, Media, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,221

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: $26,221 (112%)
Ins. Median: $26,221 (112% 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 $23,837 - $60,547 101%
Mercy Life $23,837 101%
UnitedHealthcare $23,837 - $26,602 101%
Humana $24,314 103%
Keystone First $24,314 103%
Devoted Health $25,506 109%
Health Partners/Jefferson Health $25,625 109%
Aetna $25,983 - $85,402 111%
Pa Health & Wellness $26,221 112%
Upmc $26,221 112%
Highmark Wholecare $26,459 113%
Geisinger Health $26,698 114%
Cigna $49,681 211%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1068 West Baltimore Pike, Media, PA 19063
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals