CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: St David's Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $25,724
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at St David's Medical Center is $25,724. 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 1.09x the Medicare baseline. Located in 919 E 32Nd St, Austin, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$25,724

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: $25,724 (109%)
Ins. Median: $25,724 (109% 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
Nomi Health $2,450 - $120,000 10%
Harbor Health Team $2,470 - $126,000 11%
United $2,781 - $59,970 12%
Aetna $3,463 - $26,985 15%
Cigna $5,963 - $25,976 25%
Altus Hospice (Hospice Of The Hills) $22,698 97%
Cella Bella Hospice $22,698 97%
Compassionate Care Mcr $22,698 97%
Heart To Heart Hospice $22,698 97%
Hospice Austin $22,698 97%
Hospice Compassus $22,698 97%
Silverado Hospice $22,698 97%
St David’S Hospice $22,698 97%
Moda $24,086 102%
Wellmed $24,892 106%
Angel Heart Hospice $25,220 107%
Aseracare Hospice $25,220 107%
Blue Cross Blue Shield $25,220 107%
Girling Hospice $25,220 107%
Lighthouse Hospice, Llc. $25,220 107%
Odyssey Hospice $25,220 107%
Southern Care Hospice $25,220 107%
Texas Home Health Hospice $25,220 107%
Triwest Healthcare Alliance $25,220 107%
Triwest Veterans $25,220 107%
Vistacare Family Hospice $25,220 107%
Wesleyan Homes, Inc. $25,220 107%
Devoted Health $25,724 109%
Humana $25,724 - $26,985 109%
Provider Partners Health Plan $25,724 109%
Texas Independent Health Plan $25,724 - $29,003 109%
Wellcare $25,724 - $29,003 109%
American Health Plan Of Texas $26,481 - $27,742 113%
Superior Health Plan $26,481 - $40,352 113%
Universal Health $26,481 113%
Imperial Insurance $26,733 114%
Shared Health $26,985 115%
Molina Healthcare $27,490 117%
Pyramid Life $27,742 118%
Oscar $28,473 - $31,637 121%
Austin Fc $31,525 134%
Sendero $34,047 - $43,126 145%
Corvel Corporation $35,704 152%
Naphcare $39,091 166%
Seven Corners $39,091 166%
Healthcare Highways $40,561 - $41,385 173%
Moda Health $43,723 - $44,599 186%
Curative Administrators $44,088 188%
Evry Health $44,502 189%
Covenant Management Systems $53,411 227%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 919 E 32Nd St, Austin, TX 78705
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals