CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Novant Health Hilton Head Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $30,264
Cash Discount Price: $48,554
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Novant Health Hilton Head Medical Center is $30,264. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48,554. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.29x the Medicare baseline. Located in 25 Hospital Center Blvd, Hilton Head Island, SC.

Cash / Self-Pay

$48,554

Average discount available for prompt cash payment at this facility.

Insurance Median

$30,264

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%)

Cash / Self-Pay: $48,554 (207%)

Insurance Median: $30,264 (129%)

Cash: $48,554 (207% of Medicare)

Ins. Median: $30,264 (129% 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
Absolute Total Care	$28,823 - $50,440	123%
Aetna	$28,823	123%
Devoted Health Plan	$28,823	123%
Humana	$28,823	123%
UnitedHealthcare	$28,823 - $166,472	123%
Molina	$29,399 - $50,440	125%
Cigna	$29,687	126%
Clover Insurance Company	$29,975	128%
Select Health	$30,264 - $64,563	129%
Blue Cross Blue Shield	$48,554 - $130,346	207%

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 $48,554.
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 Novant Health Hilton Head Medical Center 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.