CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Tristar Summit Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $24,368
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Tristar Summit Medical Center is $24,368. 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 1.04x the Medicare baseline. Located in 5655 Frist Blvd, Hermitage, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$24,368

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: $24,368 (104%)
Ins. Median: $24,368 (104% 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 $2,811 - $60,295 12%
Blue Cross Blue Shield $13,857 - $71,904 59%
Wellpoint $16,723 71%
Alive Hospice, Inc. $22,696 97%
Bright Health $23,651 101%
Amerigroup $23,890 102%
Humana $23,890 - $40,600 102%
Odyssey Healthcare $23,890 102%
Sarah Cannon Research $23,890 102%
Aetna $24,129 - $66,035 103%
Devoted Health Plan $24,368 104%
Healthspring $24,368 104%
Signature Advantage $24,368 104%
Apex Health $24,607 105%
Evergreen Hmo $24,607 105%
Wellcare $24,607 105%
Zing $24,607 - $26,279 105%
Atrio Golden Times $24,846 106%
Nhc Advantage, Inc. $24,846 106%
Pruitt Health (Allyalign) $24,846 106%
American Health Advantage $25,085 107%
Ambetter / Centene $25,533 - $26,554 109%
Oscar $37,143 158%
Multiplan $44,221 188%
Cigna $52,166 - $59,280 222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5655 Frist Blvd, Hermitage, TN 37076
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals