CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Methodist Hospital Stone Oak

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $26,943
  • 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 Methodist Hospital Stone Oak is $26,943. 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 1139 E Sonterra Blvd,, San Antonio, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,943

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: $26,943 (115%)
Ins. Median: $26,943 (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
Aetna $2,775 - $30,194 12%
United $2,988 - $55,282 13%
Cigna $5,717 - $7,569 24%
Wellmed $23,087 - $29,490 98%
Triwest Va Pccc $23,470 - $29,979 100%
Alamo Hospice $23,949 - $30,591 102%
Amerigroup $23,949 - $30,591 102%
Blue Cross Blue Shield $23,949 - $30,591 102%
Gonzaba Medical Group $23,949 - $30,285 102%
Ilumed $23,949 - $30,591 102%
Integranet $23,949 - $30,591 102%
Lighthouse Hospice $23,949 - $30,591 102%
Triwest $23,949 - $30,591 102%
Clover Insurance $24,428 - $31,203 104%
Devoted Health $24,428 - $31,203 104%
American Health Plan Of Texas $25,147 - $33,650 107%
Superior Health $25,147 - $32,121 107%
Imperial Insurance $25,386 - $32,427 108%
Wellcare $26,426 - $31,203 112%
Texas Independent Health Plan $26,823 - $31,203 114%
Fidelis Securecare $27,063 - $34,874 115%
Focus Healthcare Management $34,247 - $43,746 146%
Molina Healthcare $38,079 - $48,640 162%
Superior $38,606 - $49,313 164%
Healthcare Highways $42,641 181%
Evry Health $43,006 183%
Curative Administrators $44,088 188%
Focus Health Solutions $44,214 188%
Valenz $45,988 196%
Oscar $78,560 334%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1139 E Sonterra Blvd,, San Antonio, TX 78258
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals