CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Methodist Celina 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 Celina 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 1500 S Dallas Parkway, Celina, 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

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$23,097 - $37,417	98%
Blue Cross Blue Shield	$23,097 - $24,483	98%
Mcs Advantage, Inc Classicare [7021]	$23,097	98%
Medicare (plans)	$23,097 - $24,714	98%
UnitedHealthcare	$23,097 - $24,483	98%
Ust Health Proof [1005]	$23,097	98%
Wellcare [7016]	$23,097	98%
American Health Advantage Of Texas [7099]	$24,252	103%
Cigna	$24,252 - $35,489	103%
Humana	$24,483	104%
Southwestern Health Resources Swhr [7015]	$24,483	104%
Champva [1000]	$31,029	132%
Tricare	$31,029	132%
Triwest Wps [8010]	$31,029	132%
Veterans Administration [9001]	$31,029	132%
Oscar Insurance Company [2057]	$32,336	138%
Department Of Labor [8004]	$33,029	141%
Generic Workers Comp Tx Non Par [9010]	$33,029	141%
Generic Workers Comp Tx Par [8002]	$33,029	141%
Generic Workers Comp Tx Par [9011]	$33,029	141%
Molina [3017]	$33,491	142%
Sana Benefits [3069]	$34,646	147%
Web Tpa [3049]	$35,489	151%
Wellpoint Marketplace Exchange [3071]	$35,800	152%
90 Degree Benefit [3057]	$38,110	162%
Allied National [2031]	$38,110	162%
Entrust/90 Degree [2058]	$38,110	162%
Kempton Group Administrators, Tower Extrusions [3061]	$38,765	165%
Imperial Insurance Companies [3073]	$41,575	177%
Evry Health [1013]	$57,742	246%
Medical Cost Containment Professionals [3059]	$57,742	246%
Velocity [3070]	$57,742	246%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $49,021.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 451.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Methodist Celina Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 451.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.