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Lumbar spinal fusion: what insurers pay

Single-level low-back fusion, hospital stay. MS-DRG 451 (450 with MCC); 460 before FY2025. Commercial negotiated rates by hospital and market, next to Medicare for the same code.

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MS-DRG 451: Single Level Spinal Fusion Except Cervical Without McC

1393 hospitals in 81 markets. National Medicare rate $23,507.

MarketHospitals25th pctMedian75th pctLow–high
Alabama (statewide)19$27,031$33,922$37,794$21,644–$73,476
Alaska (statewide)4———$28,144–$102,032
Arizona (statewide)26$49,803$60,445$62,562$19,349–$81,393
Arkansas (statewide)7$30,415$32,963$33,608$23,775–$51,824
Atlanta GA8$55,686$59,158$71,134$55,686–$91,889
Austin TX11$20,764$34,068$36,254$20,240–$44,247
Boston MA14$28,829$29,881$33,869$24,267–$66,150
California (statewide)41$38,043$51,908$75,946$25,005–$127,105
Charlotte NC8$46,987$50,886$63,151$36,239–$63,151
Chicago IL10$38,872$45,022$52,170$29,308–$60,085
Cleveland OH11$40,612$41,947$44,461$22,338–$69,139
Colorado (statewide)16$46,697$54,699$74,697$19,792–$101,567
Columbus OH3———$65,661–$86,565
Connecticut (statewide)5$34,867$61,581$64,636$24,821–$120,687
Dallas-Fort Worth TX15$29,110$35,952$39,836$27,436–$79,015
Denver CO15$38,123$47,734$64,164$28,052–$96,889
Detroit MI14$44,251$44,251$57,674$21,865–$69,216
Florida (statewide)93$31,686$38,701$56,472$17,562–$97,032
Georgia (statewide)44$42,334$61,896$72,395$24,695–$91,889
Hawaii (statewide)6$60,978$77,926$80,689$55,724–$99,481
Houston TX19$32,076$37,099$47,567$28,684–$67,217
Idaho (statewide)13$63,774$77,181$84,412$33,332–$94,293
Illinois (statewide)37$29,881$37,637$47,656$24,457–$79,729
Indiana (statewide)44$23,139$46,624$56,466$16,326–$94,247
Indianapolis IN5$17,562$17,886$59,132$17,233–$82,078
Iowa (statewide)15$29,096$33,903$43,913$26,094–$59,171
Kansas (statewide)19$28,639$32,881$38,839$13,688–$102,032
Kentucky (statewide)21$29,976$32,012$42,464$19,080–$81,805
Las Vegas NV2———$45,373–$62,346
Los Angeles CA18$57,388$59,145$63,709$37,732–$88,784
Louisiana (statewide)25$24,235$28,788$32,210$18,210–$37,853
Maine (statewide)12$77,419$87,602$97,674$24,907–$97,674
Massachusetts (statewide)5$35,704$40,270$41,218$23,031–$57,340
Miami-Fort Lauderdale FL4———$33,807–$46,152
Michigan (statewide)35$35,998$42,310$52,274$25,456–$67,192
Minneapolis-St. Paul MN15$45,812$49,014$52,996$24,282–$61,279
Minnesota (statewide)22$40,309$41,222$56,318$14,619–$67,192
Mississippi (statewide)21$32,530$34,888$47,526$24,071–$67,770
Missouri (statewide)23$32,228$35,268$45,649$18,907–$84,934
Montana (statewide)7$37,881$52,957$65,530$14,731–$127,231
Nashville TN8$26,953$30,628$40,554$18,220–$59,251
Nebraska (statewide)13$51,720$55,067$66,102$36,129–$85,916
Nevada (statewide)3———$19,308–$64,158
New Hampshire (statewide)8$37,182$42,675$53,897$25,656–$75,979
New Jersey (statewide)20$55,660$64,478$73,631$30,387–$116,051
New Mexico (statewide)9$39,420$49,181$58,992$21,654–$92,922
New York (statewide)48$35,146$42,352$56,865$23,437–$110,498
New York City9$60,492$62,222$78,148$27,500–$99,464
North Carolina (statewide)29$33,748$43,738$63,420$19,084–$79,729
North Dakota (statewide)7$34,850$39,218$41,983$23,330–$55,718
Ohio (statewide)43$41,947$53,547$61,194$20,750–$108,180
Oklahoma (statewide)17$25,904$32,204$36,547$14,966–$63,174
Oregon (statewide)9$39,422$52,846$67,693$35,645–$83,654
Pennsylvania (statewide)58$40,758$49,890$60,372$24,882–$79,729
Philadelphia PA11$55,692$61,390$71,360$52,634–$116,051
Phoenix AZ11$60,618$60,618$61,657$55,732–$62,562
Pittsburgh PA7$36,806$39,273$43,638$31,422–$49,368
Portland OR9$62,833$68,694$80,348$62,063–$80,348
Research Triangle NC8$38,492$42,596$45,566$33,678–$49,821
Rhode Island (statewide)5$49,508$61,827$62,032$30,582–$68,086
Richmond VA7$41,310$74,250$77,725$37,337–$87,201
Rio Grande Valley TX4———$32,056–$42,905
Salt Lake City UT9$50,080$50,080$50,080$49,036–$50,080
San Antonio TX3———$34,914–$55,862
San Diego CA7$36,493$45,226$49,162$31,575–$53,196
San Francisco Bay Area CA2———$39,351–$54,482
Seattle-Tacoma WA16$70,515$71,185$76,968$69,155–$96,180
South Carolina (statewide)27$51,168$72,704$88,850$27,712–$105,483
South Dakota (statewide)3———$41,559–$52,542
St. Louis MO7$37,094$37,094$37,094$16,507–$52,459
Tampa FL11$61,686$62,379$63,446$49,942–$68,110
Tennessee (statewide)31$26,934$32,452$38,314$16,116–$59,251
Texas (statewide)85$31,798$37,499$50,261$19,827–$81,805
Utah (statewide)6$52,422$62,124$66,769$23,696–$67,425
Vermont (statewide)3———$38,581–$85,282
Virginia (statewide)21$56,248$63,707$67,234$32,914–$111,216
Washington (statewide)15$53,098$57,895$68,894$24,353–$138,229
Washington DC11$54,822$60,504$62,368$36,446–$79,729
West Virginia (statewide)13$18,645$19,527$52,926$16,260–$77,807
Wisconsin (statewide)47$55,004$61,122$67,192$14,553–$77,701
Wyoming (statewide)1———$81,279–$81,279

Lowest and highest 12 hospital medians

HospitalMarketMedian across insurers× MedicareInsurersFile date
Stormont Vail Health Flint Hills, LlcKansas (statewide)$13,6880.7×32025-12-19
Thedacare Regional Medical Center - Appleton IncWisconsin (statewide)$14,5530.7×12026-08-07
Kittson HealthcareMinnesota (statewide)$14,6190.6×12026-06-26
Mccone County Health CenterMontana (statewide)$14,7310.6×12026-01-01
Ascension St John SapulpaOklahoma (statewide)$14,9660.7×12026-01-01
Ascension Saint Thomas HickmanTennessee (statewide)$16,1160.7×42026-01-01
Wetzel County HospitalWest Virginia (statewide)$16,2600.7×22026-07-10
Schneck Medical CenterIndiana (statewide)$16,3260.7×12024-01-24
Ascension Columbia St Mary'S Hospital Milwaukee CaWisconsin (statewide)$16,3270.7×92026-01-01
Mercy Hospital SouthSt. Louis MO$16,5070.7×12026-06-10
Ascension St John NowataOklahoma (statewide)$16,8510.8×22026-01-01
Ascension St Vincent Heart CenterIndiana (statewide)$17,2050.7×72026-01-01
Carilion Roanoke Memorial HospitalVirginia (statewide)$102,3714.6×12025-12-15
Prisma Health Richland HospitalSouth Carolina (statewide)$105,4834.8×42026-03-01
Prisma Health Baptist ParkridgeSouth Carolina (statewide)$105,4834.8×42026-03-01
Lodi Community HospitalOhio (statewide)$108,1805.0×12026-06-15
Garnet Health Medical Center CatskillsNew York (statewide)$110,4983.8×82026-04-01
Carilion New River Valley Medical CenterVirginia (statewide)$111,2165.0×12025-12-15
Inspira Medical Center VinelandNew Jersey (statewide)$116,0514.4×52026-03-24
Inspira Medical Center Mullica HillPhiladelphia PA$116,0514.4×52026-03-24
Lawrence & Memorial HospitalConnecticut (statewide)$120,6874.3×132026-09-19
Lac/Rancho Los Amigos National Rehabilitation CtrCalifornia (statewide)$127,1054.2×12026-03-12
Providence St Joseph Medical CenterMontana (statewide)$127,2315.4×12026-04-01
Providence Centralia HospitalWashington (statewide)$138,2295.3×22026-04-01

Every hospital is on its state's page (linked in the market table) and in the interactive explorer.

MS-DRG 450: Single Level Spinal Fusion Except Cervical With McC Or Custom-Made Anatomically Designed Interbody Fusion Device

1301 hospitals in 81 markets. National Medicare rate $38,782.

MarketHospitals25th pctMedian75th pctLow–high
Alabama (statewide)19$42,990$55,966$65,774$35,708–$122,621
Alaska (statewide)3———$46,115–$170,274
Arizona (statewide)26$79,818$101,840$104,408$27,012–$176,974
Arkansas (statewide)5$50,250$51,268$56,651$39,676–$115,033
Atlanta GA10$92,931$105,992$121,720$92,931–$160,364
Austin TX11$34,257$55,154$56,918$33,392–$73,000
Boston MA13$47,204$49,299$56,814$40,036–$109,137
California (statewide)38$68,212$82,548$142,265$42,252–$176,974
Charlotte NC8$78,414$84,922$104,188$59,787–$104,188
Chicago IL10$64,667$75,135$87,064$48,910–$99,131
Cleveland OH11$64,378$69,133$69,918$36,756–$89,929
Colorado (statewide)16$70,007$94,103$123,238$32,654–$167,568
Columbus OH3———$108,329–$142,817
Connecticut (statewide)3———$101,598–$135,202
Dallas-Fort Worth TX15$44,767$53,625$62,533$42,642–$121,542
Denver CO15$63,382$70,878$105,859$55,525–$159,851
Detroit MI13$73,006$73,006$74,466$36,074–$96,514
Florida (statewide)92$52,232$58,307$97,336$24,633–$166,412
Georgia (statewide)44$67,059$114,076$126,270$39,162–$160,364
Hawaii (statewide)6$100,604$128,192$132,586$91,936–$164,127
Houston TX19$49,662$61,560$78,108$43,123–$103,584
Idaho (statewide)11$95,307$111,757$126,960$54,992–$157,361
Illinois (statewide)32$53,395$61,938$82,736$40,350–$176,974
Indiana (statewide)27$71,972$86,070$110,089$26,213–$155,491
Indianapolis IN4———$24,983–$135,414
Iowa (statewide)14$48,484$57,027$68,718$43,480–$97,622
Kansas (statewide)17$41,522$45,258$66,910$22,583–$170,274
Kentucky (statewide)19$49,198$55,470$70,535$31,842–$118,787
Las Vegas NV2———$45,373–$101,283
Los Angeles CA18$85,754$99,117$102,426$68,192–$122,318
Louisiana (statewide)23$41,712$48,300$54,941$29,627–$63,171
Maine (statewide)12$128,026$144,528$161,146$41,092–$161,146
Massachusetts (statewide)4———$37,998–$74,718
Miami-Fort Lauderdale FL4———$52,828–$72,398
Michigan (statewide)33$56,908$69,804$83,312$41,998–$110,856
Minneapolis-St. Paul MN14$81,893$88,441$105,507$40,166–$136,020
Minnesota (statewide)21$68,009$68,009$95,834$29,260–$141,356
Mississippi (statewide)17$48,221$62,999$88,295$40,171–$150,428
Missouri (statewide)21$51,942$58,722$73,729$31,553–$118,129
Montana (statewide)6$45,525$79,422$97,270$24,585–$224,089
Nashville TN8$47,942$48,555$65,019$45,347–$98,882
Nebraska (statewide)13$86,312$95,438$110,314$60,294–$155,778
Nevada (statewide)3———$41,892–$105,849
New Hampshire (statewide)8$68,132$73,967$89,895$52,739–$125,352
New Jersey (statewide)20$92,305$108,408$121,478$50,022–$202,988
New Mexico (statewide)9$69,552$82,075$97,220$36,108–$155,072
New York (statewide)45$58,239$70,584$93,818$33,011–$200,349
New York City9$99,802$99,951$130,416$45,894–$164,098
North Carolina (statewide)26$59,818$80,887$106,175$23,422–$176,974
North Dakota (statewide)7$58,816$65,450$69,444$45,729–$92,984
Ohio (statewide)38$66,876$83,115$99,948$34,235–$139,097
Oklahoma (statewide)14$46,648$55,520$66,169$40,609–$104,226
Oregon (statewide)7$94,982$105,002$117,462$53,279–$139,097
Pennsylvania (statewide)57$66,620$80,417$97,557$43,278–$176,974
Philadelphia PA11$92,036$101,282$117,351$86,838–$202,988
Phoenix AZ11$92,296$96,153$100,660$81,799–$104,408
Pittsburgh PA7$62,571$65,946$73,008$51,841–$83,845
Portland OR9$103,572$112,903$134,088$102,722–$134,088
Research Triangle NC5$75,346$82,196$82,196$57,964–$88,587
Rhode Island (statewide)5$102,003$102,495$109,922$52,685–$112,329
Richmond VA6$61,154$88,738$118,090$58,686–$148,771
Rio Grande Valley TX4———$52,315–$71,768
Salt Lake City UT9$82,624$82,624$82,624$81,122–$82,624
San Antonio TX3———$57,344–$80,776
San Diego CA6$56,644$67,494$82,646$51,319–$87,130
San Francisco Bay Area CA2———$60,699–$90,920
Seattle-Tacoma WA16$118,231$122,026$136,538$117,680–$160,508
South Carolina (statewide)23$82,234$117,821$150,514$45,800–$161,514
South Dakota (statewide)3———$68,566–$86,686
St. Louis MO3———$61,196–$85,883
Tampa FL11$102,746$104,102$106,212$82,396–$113,785
Tennessee (statewide)32$47,444$54,900$63,726$30,700–$122,074
Texas (statewide)85$50,338$62,875$79,400$33,089–$133,892
Utah (statewide)5$104,702$108,144$112,521$82,624–$112,521
Vermont (statewide)3———$64,387–$142,323
Virginia (statewide)17$73,442$103,943$109,096$51,392–$168,895
Washington (statewide)12$94,368$109,270$127,476$80,270–$238,606
Washington DC11$87,634$101,009$105,057$61,006–$176,974
West Virginia (statewide)13$39,361$41,225$96,157$34,326–$128,369
Wisconsin (statewide)45$94,530$101,921$110,856$48,745–$128,193
Wyoming (statewide)1———$147,370–$147,370

Lowest and highest 12 hospital medians

HospitalMarketMedian across insurers× MedicareInsurersFile date
Stormont Vail Health Flint Hills, LlcKansas (statewide)$22,5830.7×32025-12-19
Frye Regional Medical CenterNorth Carolina (statewide)$23,4220.7×12026-07-08
Ascension Via Christi Hospitals Wichita, Inc.Kansas (statewide)$23,7240.7×22026-01-01
Mccone County Health CenterMontana (statewide)$24,5850.6×12026-01-01
Ascension St Vincent'S St Johns CountyFlorida (statewide)$24,6330.6×12026-01-01
Wilson Medical CenterNorth Carolina (statewide)$24,9780.7×12026-07-10
Ascension St Vincent CarmelIndianapolis IN$24,9830.6×12026-01-01
Ascension St Vincent FishersIndianapolis IN$24,9830.6×12026-01-01
Ascension St Vincent KokomoIndiana (statewide)$26,2130.7×12026-01-01
Northern Cochise Community Hospital, Inc.Arizona (statewide)$27,0120.7×12026-07-29
Grand Itasca Clinic And HospitalMinnesota (statewide)$29,2600.8×12026-01-28
St Charles Parish HospitalLouisiana (statewide)$29,6270.8×22026-04-01
Hemet Global Medical CenterCalifornia (statewide)$176,9743.5×12026-06-15
Menifee Global Medical CenterCalifornia (statewide)$176,9743.5×12026-05-20
Medstar Washington Hospital CenterWashington DC$176,9743.9×72026-04-01
Decatur Memorial HospitalIllinois (statewide)$176,9744.3×62026-09-17
Maria Parham Medical CenterNorth Carolina (statewide)$176,9744.9×12026-07-30
Swain County HospitalNorth Carolina (statewide)$176,9744.9×22026-07-30
Conemaugh Meyersdale Medical CenterPennsylvania (statewide)$176,9744.8×32026-08-06
Garnet Health Medical Center CatskillsNew York (statewide)$200,3494.2×82026-04-01
Inspira Medical Center VinelandNew Jersey (statewide)$202,9884.7×52026-03-24
Inspira Medical Center Mullica HillPhiladelphia PA$202,9884.7×52026-03-24
Providence St Joseph Medical CenterMontana (statewide)$224,0895.8×12026-04-01
Providence Centralia HospitalWashington (statewide)$238,6065.6×22026-04-01

Every hospital is on its state's page (linked in the market table) and in the interactive explorer.

Questions

How much do commercial insurers pay hospitals for lumbar spinal fusion?

Across 1393 hospitals in 81 markets (metro areas and statewide) that post a usable dollar rate, the median commercial rate for inpatient stay (MS-DRG 451) is $46,972, 2.0× the same hospital's local Medicare base rate. The middle half of hospitals runs $33,903 to $62,379. Figures are each hospital's median across insurers, from its federal price-transparency file.

What does Medicare pay for lumbar spinal fusion?

Medicare's national inpatient base rate for MS-DRG 451 is $23,507, before local wage adjustment.

Which hospitals post the lowest and highest commercial rates for lumbar spinal fusion?

Lowest medians: Stormont Vail Health Flint Hills, Llc ($13,688), Thedacare Regional Medical Center - Appleton Inc ($14,553), Kittson Healthcare ($14,619). Highest: Providence Centralia Hospital ($138,229), Providence St Joseph Medical Center ($127,231), Lac/Rancho Los Amigos National Rehabilitation Ctr ($127,105). Coverage: every hospital whose price file we could read.