CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Holy Family Memorial

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $44,975
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.91x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Holy Family Memorial is $44,975. 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 1.91x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$44,975

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: $44,975 (191%)
Ins. Median: $44,975 (191% 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
Blue Cross Blue Shield $22,611 - $56,868 96%
Community Care Incorporated $22,611 96%
Health Partners $22,611 - $65,816 96%
Humana $22,611 96%
Icare $22,611 96%
Molina $22,611 - $24,420 96%
Network Health Plan $22,611 - $60,570 96%
Security Health Plan $22,611 96%
UnitedHealthcare $22,611 - $95,181 96%
Allwell $23,063 98%
Health Payment Systems $41,716 177%
Chorus Community Health Plan $44,428 189%
Wps Health Plan $45,521 194%
Dean Health Plan $56,221 239%
Centivo $60,218 - $72,878 256%
Medical College Of Wisconsin $65,086 277%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 Western Ave, Manitowoc, WI 54221
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals