CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Stones River Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $15,974
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.68x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Stones River Hospital is $15,974. 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 0.68x the Medicare baseline. Located in 324 Doolittle Road, Woodbury, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,974

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: $15,974 (68%)
Ins. Median: $15,974 (68% 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
Cigna $8,001 - $16,559 34%
Oscar Health $8,394 - $9,991 36%
Smart Health $10,594 - $34,405 45%
UnitedHealthcare $11,485 - $24,575 49%
Blue Cross Blue Shield $15,440 - $59,628 66%
Aetna $19,970 - $25,067 85%
Point Comfort Underwriters $22,118 94%
Amerigroup Mcr Replacement $24,575 105%
Ascension Complete $24,575 105%
Centurion Of Tn $24,575 105%
Covid Uninsured Test Fund $24,575 105%
Healthspring Mcr Replacement $24,575 105%
Humana $24,575 105%
Medicare (plans) $24,575 105%
Nhc Advantage $24,575 105%
Ambetter / Centene $31,948 136%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 324 Doolittle Road, Woodbury, TN 37190
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals