CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Memorial Hermann Sugar Land Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $26,926
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Memorial Hermann Sugar Land Hospital is $26,926. 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 1.15x the Medicare baseline. Located in 17500 W Grand Parkway South, Sugar Land, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,926

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: $26,926 (115%)
Ins. Median: $26,926 (115% 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
Kelseycare $26,118 111%
Aetna $26,926 - $44,428 115%
Amerivantage $26,926 115%
Blue Cross Blue Shield $26,926 115%
Cigna $26,926 115%
Devoted Health $26,926 115%
Humana $26,926 115%
Kaiser Permanente $26,926 115%
Medicare (plans) $26,926 115%
Memorial Hermann $26,926 115%
Tdc Prisoner $26,926 115%
UnitedHealthcare $26,926 - $43,081 115%
Wellcare $26,926 115%
Wellpoint $26,926 - $43,081 115%
Community Health $29,618 - $43,081 126%
Molina Healthcare $29,618 - $51,967 126%
Procare Advantage $30,965 132%
United Kelseyseybold $41,735 178%
Oscar $43,081 183%
Superior Healthplan $43,081 183%
90 Degrees $51,159 218%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 17500 W Grand Parkway South, Sugar Land, TX 77479
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals