CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Tristar Southern Hills Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $29,086
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Tristar Southern Hills Medical Center is $29,086. 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 1.24x the Medicare baseline. Located in 391 Wallace Rd, Nashville, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$29,086

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: $29,086 (124%)
Ins. Median: $29,086 (124% 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 $2,987 - $63,377 13%
Blue Cross Blue Shield $14,434 - $71,904 61%
Wellpoint $19,961 85%
Ambetter / Centene $25,533 - $26,554 109%
Alive Hospice, Inc. $27,089 115%
Bright Health $28,230 120%
Amerigroup $28,515 121%
Humana $28,515 - $40,600 121%
Odyssey Healthcare $28,515 121%
Sarah Cannon Research $28,515 121%
Aetna $28,800 - $66,035 123%
Devoted Health Plan $29,086 124%
Healthspring $29,086 124%
Wellcare $29,371 125%
Zing $29,371 - $31,367 125%
Nhc Advantage, Inc. $29,656 126%
American Health Advantage $29,941 127%
Evergreen Hmo $29,941 127%
Signature Advantage $29,941 127%
Apex Health $30,226 129%
Atrio Golden Times $30,511 130%
Pruitt Health (Allyalign) $30,511 130%
Oscar $37,143 158%
Multiplan $50,527 215%
Cigna $52,166 - $59,280 222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 391 Wallace Rd, Nashville, TN 37211
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals