CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: St David's South Austin Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $27,166
  • 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 St David's South Austin Medical Center is $27,166. 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 901 West Ben White Blvd, Austin, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$27,166

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: $27,166 (116%)
Ins. Median: $27,166 (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
Nomi Health $2,450 - $120,000 10%
Harbor Health Team $2,470 - $126,000 11%
United $2,781 - $59,970 12%
Aetna $3,463 - $27,965 15%
Cigna $5,963 - $27,433 25%
Altus Hospice (Hospice Of The Hills) $23,970 102%
Cella Bella Hospice $23,970 102%
Compassionate Care Mcr $23,970 102%
Heart To Heart Hospice $23,970 102%
Hospice Austin $23,970 102%
Hospice Compassus $23,970 102%
Silverado Hospice $23,970 102%
St David’S Hospice $23,970 102%
Moda $24,086 102%
Wellmed $26,287 112%
Angel Heart Hospice $26,634 113%
Aseracare Hospice $26,634 113%
Blue Cross Blue Shield $26,634 113%
Girling Hospice $26,634 113%
Harbor Hospice $26,634 113%
Lighthouse Hospice, Llc. $26,634 113%
Odyssey Hospice $26,634 113%
Southern Care Hospice $26,634 113%
Texas Home Health Hospice $26,634 113%
Triwest Veterans $26,634 113%
Vistacare Family Hospice $26,634 113%
Wesleyan Homes, Inc. $26,634 113%
Devoted Health $27,166 116%
Provider Partners Health Plan $27,166 116%
American Health Plan Of Texas $27,965 - $29,297 119%
Humana $27,965 119%
Superior Health Plan $27,965 - $42,614 119%
Texas Independent Health Plan $27,965 119%
Universal Health $27,965 119%
Wellcare $27,965 119%
Imperial Insurance $28,232 120%
Oscar $28,473 - $31,637 121%
Shared Health $28,498 121%
Molina Healthcare $29,031 124%
Pyramid Life $29,297 125%
Austin Fc $33,292 142%
Sendero $35,955 - $45,543 153%
Corvel Corporation $37,705 160%
Healthcare Highways $40,561 - $41,385 173%
Naphcare $41,282 176%
Seven Corners $41,282 176%
Moda Health $43,723 - $44,599 186%
Curative Administrators $44,088 188%
Evry Health $44,502 189%
Covenant Management Systems $53,411 227%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 West Ben White Blvd, Austin, TX 78704
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals