CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Memorial Hermann Memorial City Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $27,381
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Memorial Hermann Memorial City Hospital is $27,381. 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 1.16x the Medicare baseline. Located in 921 Gessner, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$27,381

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: $27,381 (116%)
Ins. Median: $27,381 (116% 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
Kelseycare $26,560 113%
Aetna $27,381 - $45,179 116%
Amerivantage $27,381 116%
Blue Cross Blue Shield $27,381 116%
Christus Health $27,381 116%
Cigna $27,381 116%
Devoted Health $27,381 116%
Humana $27,381 116%
Kaiser Permanente $27,381 116%
Medicare (plans) $27,381 116%
Memorial Hermann $27,381 116%
Tdc Prisoner $27,381 116%
UnitedHealthcare $27,381 - $43,810 116%
Wellcare $27,381 116%
Wellpoint $27,381 - $43,810 116%
Community Health $30,120 - $43,810 128%
Molina Healthcare $30,120 - $52,846 128%
Procare Advantage $31,489 134%
United Kelseyseybold $42,441 181%
Oscar $43,810 186%
Superior Healthplan $43,810 186%
90 Degrees $52,025 221%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 921 Gessner, Houston, TX 77024
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals