CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: North Austin Medical Center

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$27,364

about 1.2× the $23,504 Medicare rate · typically $15,385–$31,450

modeled estimate · not a bill or quote

What this hospital charges insurers

$28,243

About the fair price

about $879 over the fair price · 1.2× Medicare

Medicare pays $23,504 Fair price $27,364 This hospital $28,243

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $12,081 Priciest $28,243

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

A fair price for a Spinal fusion, single level (inpatient stay) is about $27,364 (about 1.2× the $23,504 Medicare rate). North Austin Medical Center charges insurers about $28,243 — about the fair price. Located in Austin, TX.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$2,781 - $59,970	12%
Blue Cross Blue Shieldmajor	$26,395	112%
Aetnamajor	$3,463 - $28,243	15%
Cignamajor	$5,963 - $26,923	25%
Humanamajor	$28,243	120%
Devoted Health	$26,923	115%
Healthcare Highways	$40,561 - $41,385	173%
Independent Health	$29,298	125%
Moda Health	$24,086 - $44,599	102%
Molina	$28,770	122%
Oscar Health	$28,473 - $31,637	121%
WellCare	$29,298	125%
WellMed	$26,052	111%
+ 31 smaller / regional plans	$2,450 - $126,000

Government programs also on file: Medicaid, Military & VA.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 451.

Insurance Before you use insurance

Call your insurance company to confirm North Austin Medical Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 451.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at North Austin Medical Center

Compare: Spinal fusion, single level (inpatient stay) at other TX hospitals

Childrens Medical Ctr of Dallas · Dallas $12,081
Childrens Medical Center Plano · Plano $12,081
Burleson St Joseph Health Center · Caldwell $20,211
Ascension Seton Southwest · Austin $20,240
Ascension Seton Hays · Kyle $20,376
Christus Mother Frances Hospital · Tyler $20,481
Ascension Seton Northwest · Austin $20,494
Ascension Providence · Waco $20,638

Insurance negotiated median for the same procedure, sorted lowest first.