CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Texas Orthopedic Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $24,252
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Texas Orthopedic Hospital is $24,252. 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 1.03x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$24,252

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: $24,252 (103%)
Ins. Median: $24,252 (103% 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 - $111,445 10%
Coventry National First Health $2,855 12%
United $3,368 - $40,933 14%
Humana $22,381 - $47,390 95%
Oscar $22,635 - $43,460 96%
Cigna $22,866 - $78,970 97%
Wellmed $22,866 97%
Amerigroup $23,097 98%
Blue Cross Blue Shield $23,097 98%
Kelsey Seybold $23,097 98%
Texas Healthcare Foundation $23,097 98%
Triwest Healthcare Alliance $23,097 98%
Van Lang Ipa $23,328 99%
Devoted Health $23,559 100%
Integranet Amerigroup Ipa $23,559 100%
Provider Partners Health Plan Of Texas $23,559 100%
American Health Plan $24,252 103%
Procare Advantage $24,252 103%
Superior Health Plan $24,252 103%
Texas Independent Health Plan $24,483 104%
Wellcare $24,483 104%
Shared Health $24,714 105%
Universal Healthcare Group $24,945 106%
Molina $25,176 107%
Verda Health Plan $25,407 108%
Fidelis Securecare Of Tx $25,869 110%
Averde Health $29,074 124%
Imagine Health $32,049 136%
Corvel Corporation $32,698 139%
Community Health Choice $33,491 142%
Omni Healthcare $34,680 148%
Superior $35,800 152%
Healthcare Highways $39,304 167%
Curative Administrators $44,088 188%
Evry Health $45,158 192%
Molina Healthcare $48,081 205%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals