CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Medical City Plano

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $26,995
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Medical City Plano is $26,995. 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 1.15x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,995

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: $26,995 (115%)
Ins. Median: $26,995 (115% 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
Aetna $2,599 - $25,375 11%
United $4,100 - $128,309 17%
Multiplan Phcs $11,348 48%
Humana $25,195 - $95,235 107%
Blue Cross Blue Shield $25,632 109%
Wellmed $25,633 109%
Amerigroup $25,710 109%
Integranet $25,710 109%
Triwest Veterans $25,710 109%
Wellcare $25,710 109%
Care N Care $25,967 110%
Cigna $26,224 - $175,947 112%
Devoted Health $26,224 112%
Mutual Of Omaha $26,224 112%
Provider Partners Health Plan $26,224 112%
Texas Independent Health Plan $26,224 112%
American Health Plan Of Texas, Inc. $26,995 115%
Procare Advantge $26,995 115%
Superior Health Plan $26,995 115%
Imperial Insurance Company $27,252 116%
Universal Healthcare Group $27,766 118%
Molina $28,024 119%
Verda Health Plan $28,281 120%
Bravo Health $28,538 121%
Fidelis Securecare $29,052 124%
Usa Managed Care $34,927 149%
Oscar $36,089 154%
Corvel Corporation $36,397 155%
Healthcare Highways $41,265 176%
Curative Administrators $44,088 188%
Evry Health $45,629 194%
Superior $46,020 - $57,590 196%
Molina Healthcare $56,619 241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3901 W 15Th St, Plano, TX 75075
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals