CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: St Josephs Community Hospital West Bend

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence
A fair price for this
$46,483
about 2.0× the $23,504 Medicare rate · typically $24,728–$63,096
modeled estimate · not a bill or quote
What this hospital charges insurers
$59,149
Above the fair price
about $12,666 over the fair price · 2.5× Medicare
Medicare pays $23,504 Fair price $46,483 This hospital $59,149

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

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

Cheapest $15,202 Priciest $59,149

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

A fair price for a Spinal fusion, single level (inpatient stay) is about $46,483 (about 2.0× the $23,504 Medicare rate). St Josephs Community Hospital West Bend charges insurers about $59,149 — above the fair price. Located in West Bend, WI.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $46,483. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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 $22,973 - $95,181 98%
Blue Cross Blue Shieldmajor $22,973 - $100,540 98%
Aetnamajor $23,432 100%
Humanamajor $22,973 98%
Health Net $71,456 304%
HealthPartners $22,973 - $65,816 98%
Molina $22,973 98%
Security Health Plan $22,973 98%
+ 9 smaller / regional plans $22,973 - $84,656

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

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

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Facility Profile & Credentials

  • Address: 3200 Pleasant Valley Road, West Bend, WI 53095
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals