CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: HCA Houston Healthcare West

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $31,237
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.33x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at HCA Houston Healthcare West is $31,237. 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 1.33x the Medicare baseline. Located in 12141 Richmond Ave, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$31,237

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: $31,237 (133%)
Ins. Median: $31,237 (133% 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 $2,591 - $37,000 11%
Coventry National First Health $2,855 12%
Aetna $16,516 - $34,918 70%
Cigna $27,736 - $75,129 118%
Averde Health $29,074 124%
Humana $29,969 - $47,390 128%
Oscar $30,309 - $43,460 129%
Wellmed $30,686 131%
Amerigroup $30,928 132%
Chc Harris Health $30,928 132%
Integranet Amerigroup Ipa $30,928 132%
Kelsey Seybold $30,928 132%
Texas Healthcare Foundation $30,928 132%
Triwest Healthcare Alliance $30,928 132%
Blue Cross Blue Shield $30,996 132%
Texas Independent Health Plan $31,237 133%
Van Lang Ipa $31,237 133%
Wellcare $31,237 133%
Devoted Health $31,547 134%
Provider Partners Health Plan Of Texas $31,547 134%
Imagine Health $32,049 136%
American Health Plan $32,474 138%
Procare Advantage $32,474 138%
Superior Health Plan $32,474 138%
Shared Health $33,093 141%
Universal Healthcare Group $33,402 142%
Fidelis Securecare Of Tx $33,712 143%
Molina $33,712 143%
Verda Health Plan $34,021 145%
Healthcare Highways $39,304 167%
Corvel Corporation $43,785 186%
Curative Administrators $44,088 188%
Community Health Choice $44,846 191%
Evry Health $45,158 192%
Omni Healthcare $46,438 198%
Superior $47,938 204%
Molina Healthcare $50,378 214%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12141 Richmond Ave, Houston, TX 77082
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals