CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Tristar Northcrest Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $24,257
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Tristar Northcrest Medical Center is $24,257. 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 1.03x the Medicare baseline. Located in 100 Northcrest Drive, Springfield, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$24,257

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: $24,257 (103%)
Ins. Median: $24,257 (103% 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
United $2,907 - $62,368 12%
Wellpoint $16,647 71%
Alive Hospice $21,404 91%
Molina $22,593 96%
Wellcare $22,593 - $23,782 96%
Bright Health $23,544 100%
Amerigroup $23,782 101%
Humana $23,782 - $40,600 101%
Aetna $24,020 - $66,035 102%
Devoted Health Plan $24,257 103%
Healthspring $24,257 103%
Evergreen Hmo $24,495 104%
Zing $24,495 - $26,160 104%
Atrio Golden Times $24,733 105%
Blue Cross Blue Shield $24,733 - $28,654 105%
Nhc Advantage, Inc. $24,733 105%
American Health Advantage $24,971 106%
Ambetter / Centene $25,533 - $26,554 109%
Oscar $37,143 158%
Cigna $52,166 - $59,280 222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Northcrest Drive, Springfield, TN 37172
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals