CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: HCA Houston Healthcare Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $26,624
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at HCA Houston Healthcare Medical Center is $26,624. 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 1.13x the Medicare baseline. Located in 1313 Hermann Dr, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,624

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: $26,624 (113%)
Ins. Median: $26,624 (113% 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%
Humana $24,806 - $47,390 106%
Oscar $25,088 - $43,460 107%
Cigna $25,344 - $75,129 108%
Wellmed $25,344 108%
Blue Cross Blue Shield $25,600 109%
Triwest Healthcare Alliance $25,600 109%
Van Lang Ipa $25,856 110%
Devoted Health $26,112 111%
Integranet Amerigroup Ipa $26,112 111%
Provider Partners Health Plan Of Texas $26,112 111%
Texas Independent Health Plan $26,624 113%
Wellcare $26,624 113%
American Health Plan $26,880 114%
Procare Advantage $26,880 114%
Superior Health Plan $26,880 114%
Shared Health $27,392 117%
Molina $27,904 119%
Verda Health Plan $28,160 120%
Community Health Choice $37,120 158%
Healthcare Highways $39,304 167%
Superior $39,680 169%
Curative Administrators $44,088 188%
Evry Health $45,158 192%
Molina Healthcare $47,603 203%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1313 Hermann Dr, Houston, TX 77004
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals