CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Reston Hospital Center

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$35,287

about 1.5× the $23,504 Medicare rate · typically $26,589–$57,825

modeled estimate · not a bill or quote

What this hospital charges insurers

$28,330

Below the fair price — a good deal

about $6,957 under the fair price · 1.2× Medicare

Medicare pays $23,504 Fair price $35,287 This hospital $28,330

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 $28,330

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 $35,287 (about 1.5× the $23,504 Medicare rate). Reston Hospital Center charges insurers about $28,330 — below the fair price — a good deal. Located in Reston, 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	$4,250 - $61,914	18%
Blue Cross Blue Shieldmajor	$3,240 - $60,384	14%
Aetnamajor	$26,306 - $82,437	112%
Cignamajor	$26,270 - $81,736	112%
Humanamajor	$25,755	110%
Devoted Health	$26,270	112%
Sentara	$25,755 - $53,783	110%
+ 7 smaller / regional plans	$26,270 - $28,330

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, 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 Reston Hospital 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 Reston Hospital 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.