CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Methodist Hospitals of Memphis

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $25,207
Cash Discount Price: $31,631
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Methodist Hospitals of Memphis is $25,207. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31,631. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.07x the Medicare baseline. Located in 1265 Union Ave Suite 700, Memphis, TN.

Cash / Self-Pay

$31,631

Average discount available for prompt cash payment at this facility.

Insurance Median

$25,207

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: $31,631 (135%)

Insurance Median: $25,207 (107%)

Cash: $31,631 (135% of Medicare)

Ins. Median: $25,207 (107% 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
Medicaid / KanCare	$2,500 - $19,578	11%
UnitedHealthcare	$20,751 - $52,982	88%
Tricare	$23,237	99%
American Health Advantage Mcr Adv [450117]	$24,835	106%
Blue Cross Blue Shield	$24,835 - $59,035	106%
Carecentrix [450200]	$24,835	106%
Generic Hospice Vbid [10940000101]	$24,835	106%
Humana	$24,835	106%
Medicare (plans)	$24,835 - $26,725	106%
Va Hospital [600005]	$24,835	106%
Devoted Health [450111]	$25,580	109%
Health Plans Inc [100282]	$26,725	114%
Cigna	$28,262 - $58,006	120%
United Food & Commercial Workers [100309]	$58,006	247%

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 $31,631.
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 Methodist Hospitals of Memphis 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.