CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Ahn Wexford Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $23,107
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Ahn Wexford Hospital is $23,107. 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 0.98x the Medicare baseline. Located in 12351 Perry Highway, Wexford, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$23,107

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: $23,107 (98%)

Ins. Median: $23,107 (98% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$12,113 - $42,227	52%
Life Pittsburgh	$21,595	92%
UnitedHealthcare	$21,595 - $23,323	92%
Aetna	$22,459 - $57,701	96%
Amerihealth	$22,675	96%
Highmark Wholecare	$22,891	97%
Humana	$22,891	97%
Medicare (plans)	$22,891 - $25,051	97%
Cigna	$23,107 - $64,336	98%
Jefferson Health Plans	$23,323	99%
Molina	$23,539	100%
American Health Plans	$23,755	101%
Martin'S Point	$31,029	132%
Medical Mutual	$64,336	274%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 451.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ahn Wexford Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 451.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.