CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Christus Mother Frances Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $19,231
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.82x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Christus Mother Frances Hospital is $19,231. 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 0.82x the Medicare baseline. Located in 800 East Dawson, Tyler, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$19,231

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: $19,231 (82%)
Ins. Median: $19,231 (82% 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Humana $3,408 - $19,231 14%
UnitedHealthcare $4,398 - $19,231 19%
Phcs $9,371 40%
Christus Health $18,270 - $26,924 78%
Aetna $19,231 82%
Allwell $19,231 82%
Blue Cross Blue Shield $19,231 - $31,144 82%
Cigna $19,231 - $51,073 82%
Triwest $19,231 82%
Washington National $19,231 82%
Wellcare $19,231 82%
Peoples Health $19,808 84%
Provider Partners Health Plan $19,808 84%
Shared Health Insurance Company $20,193 86%
Amerigroup $20,770 88%
Imperial Health Plan $21,154 90%
Medicare (plans) $21,154 90%
Procare Advantage $21,154 90%
Healthcare Highways $25,811 110%
Naphcare Inc. $44,232 188%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 East Dawson, Tyler, TX 75701
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals