CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Providence Holy Family Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $30,306
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Providence Holy Family Hospital is $30,306. 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 1.29x the Medicare baseline. Located in 5633 North Lidgerwood, Spokane, WA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$30,306

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: $30,306 (129%)
Ins. Median: $30,306 (129% 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
Kaiser $27,551 117%
Molina $27,551 - $29,755 117%
Blue Cross Blue Shield $28,653 - $49,591 122%
Providence Health Plan $28,653 122%
UnitedHealthcare $29,479 - $72,501 125%
Blue Shield $29,755 127%
Amerigroup $30,306 129%
Community Health Plan Of Washington $30,306 129%
Humana $30,306 129%
Community Health Plan $44,081 188%
Coordinated Care $44,081 - $50,969 188%
Cigna $62,179 265%
Aetna $64,771 276%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5633 North Lidgerwood, Spokane, WA 99208
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals