CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Womans Hospital of Texas,The

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $46,490
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.98x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Womans Hospital of Texas,The is $46,490. 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 1.98x the Medicare baseline. Located in 7600 Fannin, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$46,490

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: $46,490 (198%)
Ins. Median: $46,490 (198% 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 $2,415 - $4,837 10%
United $2,450 - $46,072 10%
Coventry National First Health $2,855 12%
Averde Health $29,074 124%
Imagine Health $32,049 136%
Kelsey Care (Boon-Chapman) $34,174 145%
Healthcare Highways $39,304 167%
Oscar $43,460 - $45,560 185%
Curative Administrators $44,088 188%
Humana $45,049 - $47,390 192%
Evry Health $45,158 192%
Wellmed $46,201 197%
Amerigroup $46,490 198%
Cigna $46,490 - $78,970 198%
Integranet Amerigroup Ipa $46,490 198%
Texas Healthcare Foundation $46,490 198%
Texas Independent Health Plan $46,490 198%
Triwest Healthcare Alliance $46,490 198%
Wellcare $46,490 198%
Blue Cross Blue Shield $46,668 199%
Van Lang Ipa $46,955 200%
Devoted Health $47,420 202%
Provider Partners Health Plan Of Texas $47,420 202%
Kelsey Seybold $47,885 204%
American Health Plan $48,815 208%
Procare Advantage $48,815 208%
Superior Health Plan $48,815 208%
Shared Health $49,745 212%
Universal Healthcare Group $50,209 214%
Molina $50,674 216%
Verda Health Plan $51,139 218%
Fidelis Securecare Of Tx $53,464 227%
Molina Healthcare $54,103 230%
Corvel Corporation $65,816 280%
Community Health Choice $67,411 287%
Omni Healthcare $69,805 297%
Superior $72,060 307%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7600 Fannin, Houston, TX 77054
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals