CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: SSM Health St Agnes Hospital-Fond Du Lac

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence
A fair price for this
$36,537
about 1.6× the $23,504 Medicare rate · typically $22,140–$55,872
modeled estimate · not a bill or quote
What this hospital charges insurers
$43,222
Above the fair price
about $6,685 over the fair price · 1.8× Medicare
Medicare pays $23,504 Fair price $36,537 This hospital $43,222

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 $43,222

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 $36,537 (about 1.6× the $23,504 Medicare rate). SSM Health St Agnes Hospital-Fond Du Lac charges insurers about $43,222 — above the fair price. Located in Fond Du Lac, 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 $36,537. 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.

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Humana AetnaCignaKaiser 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 $23,654 - $48,660 101%
Blue Cross Blue Shieldmajor $23,654 - $50,385 101%
Humanamajor $23,654 101%
Dean Health Plan $23,654 101%
Molina $17,740 75%
Quartz $44,168 188%
WellCare $24,127 103%
+ 9 smaller / regional plans $23,654 - $66,455

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: 430 E Division St, Fond Du Lac, WI 54935
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals