CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Christus St Michael Health System

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $20,000
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.85x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Christus St Michael Health System is $20,000. 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 0.85x the Medicare baseline. Located in 2600 St Michael Dr, Texarkana, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$20,000

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: $20,000 (85%)
Ins. Median: $20,000 (85% 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
Ppoplus Llc $2,960 13%
Zelis $2,960 13%
UnitedHealthcare $3,132 - $20,000 13%
Aetna $3,259 - $22,811 14%
Five Point Credit Union $4,190 - $10,056 18%
Healthcare Highways $5,111 22%
Beechstreet $9,371 40%
Multiplan $9,371 40%
Phcs $9,371 40%
Christus Health $19,000 - $27,999 81%
Blue Cross Blue Shield $20,000 - $42,982 85%
Coventry $20,000 85%
Humana $20,000 - $55,576 85%
Molina $20,000 85%
Texas Healthspring $20,000 85%
Triwest $20,000 85%
Windsor $20,000 85%
Provider Partners Health Plan $20,600 88%
Texas Independence Health Plan $20,600 88%
Shared Health Insurance Company $21,000 89%
Tribute Health Plan $21,000 89%
Us Imaging Network $21,400 91%
Amerigroup $21,600 92%
Imperial Health Plan $22,000 94%
Medicare (plans) $22,000 94%
Procare Advantage $22,000 94%
State Of Oklahoma $33,053 141%
Cigna $34,801 148%
Qualchoice $44,235 188%
Naphcare Inc. $45,999 196%
Healthsmart $48,694 207%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2600 St Michael Dr, Texarkana, TX 75503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals