CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Carilion Medical Center

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$29,264

about 1.2× the $23,504 Medicare rate · typically $26,096–$43,014

modeled estimate · not a bill or quote

What this hospital charges insurers

$28,276

About the fair price

about $988 under the fair price · 1.2× Medicare

Medicare pays $23,504 Fair price $29,264 This hospital $28,276 Cash price $54,575 Hospital's list price $155,928

How we calculate the fair BaseRate →

How this hospital compares to other VA hospitals

Highest price of the 9 VA hospitals we have prices for — worth calling around.

Cheapest $23,769 Priciest $28,276

Black dot = this hospital, among the 9 VA hospitals with a price for this procedure. Full list below.

A fair price for a Spinal fusion, single level (inpatient stay) is about $29,264 (about 1.2× the $23,504 Medicare rate). Carilion Medical Center charges insurers about $28,276, or about $54,575 in cash — about the fair price. Located in Roanoke, VA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$28,414 - $127,455	121%
Blue Cross Blue Shieldmajor	$28,138 - $102,371	120%
Aetnamajor	$25,931 - $103,536	110%
Cignamajor	$105,095 - $112,268	447%
Humanamajor	$19,977 - $28,138	85%
Sentara	$28,966 - $96,675	123%
+ 8 smaller / regional plans	$96,675 - $148,131

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 54,575), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 451.

Insurance Before you use insurance

Call your insurance company to confirm Carilion Medical Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 451.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Carilion Medical Center

Compare: Spinal fusion, single level (inpatient stay) at other VA hospitals

Sovah Health Danville · Danville $23,769
Lewisgale Hospital Alleghany · Low Moor $24,013
Virginia Hospital Center · Arlington $24,117
Chesapeake General Hospital · Chesapeake $24,175
Sentara Rmh Medical Center · Harrisonburg $24,212
Lewisgale Hospital Pulaski · Pulaski $24,643
Sentara Halifax Regional Hospital · South Boston $24,661
Spotsylvania Regional Medical Center · Fredericksburg $26,268

Insurance negotiated median for the same procedure, sorted lowest first.