CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: St Luke's Patients Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $27,528
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at St Luke's Patients Medical Center is $27,528. 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 1.17x the Medicare baseline. Located in 4600 East Sam Houston Parkway South, Pasadena, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$27,528

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: $27,528 (117%)
Ins. Median: $27,528 (117% 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 $4,639 - $21,851 20%
Blue Cross Blue Shield $21,422 91%
Cigna $21,422 - $72,678 91%
Humana $21,422 - $32,712 91%
Kelsey $21,422 91%
United $21,806 - $35,770 93%
Amerivantage $22,065 94%
Devoted $22,922 98%
Scanhealth $22,922 98%
Ambetter / Centene $32,133 137%
Community Health Choice $32,133 137%
Wellpoint $32,133 137%
PHCS $57,023 243%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4600 East Sam Houston Parkway South, Pasadena, TX 77505
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals