CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Froedtert Community Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $44,903
  • 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 Froedtert Community Hospital is $44,903. 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 4805 S Moorland Rd, New Berlin, WI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$44,903

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: $44,903 (191%)
Ins. Median: $44,903 (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 $22,893 - $73,343 97%
Care Wisconsin $22,893 97%
Community Care $22,893 97%
Health Partners $22,893 - $65,816 97%
Humana $22,893 97%
Icare $22,893 97%
Molina $22,893 97%
Network Health Plan $22,893 - $44,903 97%
Security Health Plan Secure Savers $22,893 97%
UnitedHealthcare $22,893 - $68,068 97%
Centivo $45,881 - $52,171 195%
Medical College Of Wisconsin $46,550 198%
Cigna $47,639 203%
Chorus Community Health Plan $51,525 219%
Sheboygan Employers Health Network $52,526 223%
Wisconsin Physician Services $52,526 223%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4805 S Moorland Rd, New Berlin, WI 53151
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals