CMS Price Transparency Data
Spinal fusion, single level (inpatient stay)
Facility: Methodist Southlake Medical Center
Billing Code: 451 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 451
- Insurance Median: $31,029
- Cash Discount Price: $49,021
- vs. Medicare Baseline: 1.32x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Methodist Southlake Medical Center is $31,029. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49,021. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.32x the Medicare baseline. Located in 421 E State Highway 114, Southlake, TX.
Cash / Self-Pay
$49,021
Average discount available for prompt cash payment at this facility.
Insurance Median
$31,029
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%)
Cash / Self-Pay: $49,021 (209%)
Insurance Median: $31,029 (132%)
Cash: $49,021 (209% of Medicare)
Ins. Median: $31,029 (132% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bind Benefits Inc [1004] | $15,921 | 68% |
| Definity Health [3006] | $15,921 | 68% |
| Freedom Life Insurance Company [2029] | $15,921 | 68% |
| Geha Federal [3066] | $15,921 | 68% |
| Tml Intergovernmental Employee Benefits [3050] | $15,921 | 68% |
| UnitedHealthcare | $15,921 - $24,525 | 68% |
| Aetna | $23,137 - $54,910 | 98% |
| Blue Cross Blue Shield | $23,137 - $24,525 | 98% |
| Medicare (plans) | $23,137 - $24,756 | 98% |
| Ust Health Proof [1005] | $23,137 | 98% |
| Wellcare [7016] | $23,137 | 98% |
| American Health Advantage Of Texas [7099] | $24,294 | 103% |
| Cigna | $24,294 - $35,489 | 103% |
| Globalhealth [1003] | $24,294 | 103% |
| Procare Advantage [7018] | $24,294 | 103% |
| Humana | $24,525 | 104% |
| Southwestern Health Resources Swhr [7015] | $24,525 | 104% |
| Provider Partners Health Plan [7025] | $25,450 | 108% |
| Mcs Advantage, Inc Classicare [7021] | $26,144 | 111% |
| Medical Card System [2063] | $26,144 | 111% |
| Alternative Service Concepts [8005] | $28,921 | 123% |
| Champva [1000] | $31,029 | 132% |
| Tricare | $31,029 | 132% |
| Triwest Wps [8010] | $31,029 | 132% |
| Veterans Administration [9001] | $31,029 | 132% |
| Bright Healthcare [2222] | $31,918 | 136% |
| Oscar Insurance Company [2057] | $32,391 | 138% |
| Department Of Labor [8004] | $33,085 | 141% |
| Generic Workers Comp Tx Non Par [9010] | $33,085 | 141% |
| Generic Workers Comp Tx Par [8002] | $33,085 | 141% |
| Generic Workers Comp Tx Par [9011] | $33,085 | 141% |
| Tristar Risk Management [8006] | $33,085 | 141% |
| Molina [3017] | $33,548 | 143% |
| Sana Benefits [3069] | $34,705 | 148% |
| Web Tpa [3049] | $35,489 - $54,910 | 151% |
| Wellpoint Marketplace Exchange [3071] | $35,862 | 153% |
| 90 Degree Benefit [3057] | $38,176 | 162% |
| Allied National [2031] | $38,176 | 162% |
| Entrust/90 Degree [2058] | $38,176 | 162% |
| Kempton Group Administrators, Tower Extrusions [3061] | $38,765 | 165% |
| Friday Health Plan [2061] | $39,332 | 167% |
| Ambetter / Centene | $39,564 | 168% |
| Imperial Insurance Companies [3073] | $41,646 | 177% |
| Scott & White Health Plan Trs [3062] | $47,080 | 200% |
| Evry Health [1013] | $57,842 | 246% |
| Medical Cost Containment Professionals [3059] | $57,842 | 246% |
| Velocity [3070] | $57,842 | 246% |
| Dart Member Care [3039] | $62,469 | 266% |
| Healthscope Benefits [2052] | $62,469 | 266% |
| Healthscope Benefits [3063] | $62,469 | 266% |