CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Orthopaedic Hospital of Wisconsin

Billing Code: 451 (MS-DRG)

The BaseRate · fair price medium confidence

A fair price for this

$34,934

about 1.5× the $23,504 Medicare rate · typically $21,014–$64,466

modeled estimate · not a bill or quote

What this hospital charges insurers

$22,143

Below the fair price — a good deal

about $12,791 under the fair price · 0.9× Medicare

Medicare pays $23,504 Fair price $34,934 This hospital $22,143

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

One of the lower prices — 6 of 8 other WI hospitals charge more for the same procedure.

Cheapest $15,202 Priciest $25,246

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 $34,934 (about 1.5× the $23,504 Medicare rate). Orthopaedic Hospital of Wisconsin charges insurers about $22,143 — below the fair price — a good deal. Located in Glendale, WI.

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	$22,143	94%
Blue Cross Blue Shieldmajor	$22,143	94%
Humanamajor	$22,143	94%
Molina	$48,714	207%

Government programs also on file: Medicare.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 451.

Insurance Before you use insurance

Call your insurance company to confirm Orthopaedic Hospital of Wisconsin is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 451.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

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

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Orthopaedic Hospital of Wisconsin

Compare: Spinal fusion, single level (inpatient stay) at other WI hospitals

Ascension Sacred Heart Rehabilitation Hospital · Mequon $15,202
Ascension Columbia St Marys Hospital Milwaukee · Milwaukee $15,215
Thedacare Regional Med Ctr - Neenah · Neenah $22,570
Sauk Prairie Hospital · Prairie Du Sac $22,833
Oakleaf Surgical Hospital · Altoona $22,877
The Monroe Clinic · Monroe $22,975
Mile Bluff Medical Center · Mauston $23,232
Beloit Health System · Beloit $25,246

Insurance negotiated median for the same procedure, sorted lowest first.