CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Aurora Memorial Hospital Burlington

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $58,116
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.47x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Aurora Memorial Hospital Burlington is $58,116. 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 2.47x the Medicare baseline. Located in 252 McHenry St, Burlington, WI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$58,116

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: $58,116 (247%)
Ins. Median: $58,116 (247% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 247% of the Medicare baseline (a markup of 147%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $46,407 197%
Blue Cross Blue Shield $50,268 - $66,355 214%
Healthpartners $50,746 - $58,116 216%
Quartz One $51,536 219%
Everpointe Elite $53,487 228%
Aurora Caregiver $55,008 234%
UnitedHealthcare $56,585 - $69,889 241%
Common Ground $56,770 242%
Health Payment Systems $57,091 243%
Molina Exchange $59,584 254%
Quartz Group $60,300 257%
Wisconsin Physician Service $61,936 - $65,195 264%
Trilogy $63,177 269%
Hs Technology $63,390 270%
Cigna $67,892 289%
Centivo $69,126 294%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 252 McHenry St, Burlington, WI 53105
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals