CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Ascension Sacred Heart Rehabilitation Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $15,215
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.65x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Ascension Sacred Heart Rehabilitation Hospital is $15,215. 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 0.65x the Medicare baseline. Located in 13111 N Port Washington Rd, Mequon, WI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,215

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: $15,215 (65%)
Ins. Median: $15,215 (65% 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 $10,022 - $21,788 43%
Smarthealth $11,771 50%
Network Health Plan $13,208 56%
Sehn C89 $13,878 59%
Humana $14,513 - $18,957 62%
Cchp Marketplace $14,524 62%
Alliance $14,865 63%
Health Payment Systems $15,215 65%
UnitedHealthcare $16,883 72%
Centivo $17,688 75%
Arise $17,737 75%
Wps $19,707 84%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13111 N Port Washington Rd, Mequon, WI 53097
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL