Spinal Fusion Cost in Connecticut (2026): Average Prices & What You'll Pay
What does a spinal fusion cost in Connecticut?
A typical spinal fusion in Connecticut costs $6,699–$13,558 for a commercially insured patient, including facility and physician fees. The median reported facility price across 17 hospitals is $4,704. This estimate is based on CMS fee schedules and hospital price transparency data published under federal law.
Yale New Haven Health and Hartford HealthCare together cover most of the state's hospital capacity, and Connecticut has some of the highest commercial insurance reimbursement rates in the US — a reflection of high labor costs, high cost-of-living, and limited market competition. Prices here routinely run 20–40% above the national median for the same services.
Spinal fusion is among the highest-cost elective surgeries, with total episode costs (implant hardware, facility, anesthesia, and post-acute care) commonly exceeding $50,000 for multi-level procedures. The implant components alone can account for $15,000–$40,000 of the facility charge, and prices vary dramatically across hospitals for identical hardware. Seeking a second surgical opinion and confirming bundled vs. itemized billing before scheduling are the most impactful steps you can take.
The same spinal fusion that costs $1,036 at Norwalk Hospital in Norwalk reaches $100,586 at HOSPITAL OF CENTRAL CONNECTICUT AT NEW BRITAIN D/B/A THE HOSPITAL OF CENTRAL CONNECTICUT in New Britain — a 97.1× gap across the 17 Connecticut hospitals reporting prices. Half of Connecticut facilities price it at or below $4,704, with most clustered between $3,298 and $5,246. Self-pay patients are quoted more than insurers actually pay: the median cash price is $4,704 versus a median negotiated rate of $4,198. Location within the state matters too: Bristol has the lowest metro median ($3,451) while Wallingford runs highest ($7,104) — a 2.1× difference inside Connecticut alone.
Forecast your out-of-pocket cost
- Lower-cost hospitals (bottom 25%): under $3,298
- Median hospital: $4,704
- Higher-cost hospitals (top 30%): $5,246+
That's a 2× spread for the same procedure — driven entirely by which facility you choose, not by clinical complexity.
- Patient A (higher-rate plan or out-of-network): ~$5,246
- Patient B (lower-rate in-network plan): ~$3,582
Where spinal fusion costs vary in Connecticut
Pins show hospitals with price-transparency data (colored by vs. state average) and nearby ambulatory surgery centers, imaging centers, and other facilities (colored by type). Click any pin for facility name and estimated cost range.
See every Connecticut hospital's price
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Cheapest Spinal Fusion Providers in Connecticut
Based on declared cash/self-pay prices from CMS hospital price transparency files.
| # | Facility | City | Price | vs Median |
|---|---|---|---|---|
| 1 | Norwalk Hospital | Norwalk, CT | $3,027 | -$1,677 |
| 2 | Prospect Waterbury, Inc | Waterbury, CT | $3,118 | -$1,586 |
| 3 | Bristol Hospital, Inc | Bristol, CT | $3,211 | -$1,493 |
| 4 | UCONN Health | CT | $3,327 | -$1,377 |
| 5 | Bristol Hospital, Inc | Bristol, CT | $3,691 | -$1,013 |
| 6 | Prospect Waterbury, Inc | Waterbury, CT | $3,863 | -$841 |
| 7 | Sharon Hospital | Po Box 789, CT | $4,523 | -$181 |
| 8 | Prospect Manchester Hospital, Inc | Manchester, CT | $4,704 | +$0 |
Prices are declared self-pay rates. Contact each facility for a formal quote before scheduling.
The facility you choose matters more than almost anything else — the same procedure, same quality, same state can cost 5× more at one hospital versus the one down the road.
→ Compare all procedure costs → Spinal Fusion costs nationwide
Check YOUR hospital's pricing → Estimate YOUR exact cost →
What you'll actually pay — example scenarios
| Your situation | Estimated out-of-pocket |
|---|---|
| Deductible not yet met (pay in full) | ~$9,899 |
| Deductible met — 20% coinsurance | ~$1,980 |
| Out-of-network provider | $21,778+ |
Based on a typical episode cost of $9,899 (facility + physician fees). Your actual cost depends on your plan deductible, coinsurance rate, and network tier. Get YOUR personalized estimate →
What this means for you
If you haven't met your deductible, you are effectively a cash-pay patient.
That means:
- You should verify your hospital is in-network before an elective visit when possible
- The cheapest facility can save you $3,362+ vs. the median.
This is the single biggest lever most patients have to reduce their cost.
Lower-cost options in Connecticut start around $3,298 or below. Most hospitals cluster between $3,298 and $5,246. A smaller group reports prices above that — often academic medical centers or high-cost markets.
If you're comparing specific hospitals, the lowest self-pay rates reported in this dataset include: Danbury Hospital in Danbury (cash price from $3,001); Norwalk Hospital in Norwalk (cash price from $3,027); Bristol Hospital, Inc in Bristol (cash price from $3,211). These are declared cash prices — contact each facility for a formal quote before scheduling.
How where you go changes what you pay for spinal fusion
The same spinal fusion bundles different services depending on the setting — facility fee, surgeon fee, and anesthesia each arrive as separate bills. Estimated ranges below reflect the typical full bundled cost, including all expected charges.
- Facility fee $1,342–$12,866
- Professional fee $569–$7,784
Estimated from CMS fee schedules + commercial rate multipliers
- Facility fee $1,342–$3,863
- Professional fee $569–$7,784
Estimated from CMS fee schedules + commercial rate multipliers
- Best value hospitals (lowest prices): Gaylord Hospital Inc: $1,342; Danbury Hospital: $3,001; Norwalk Hospital: $3,027
- Most expensive (outpatient): Griffin Hospital: ~$5,823; HOSPITAL OF CENTRAL CONNECTICUT AT NEW BRITAIN D/B/A THE HOSPITAL OF CENTRAL CONNECTICUT: ~$5,246
→ Choosing the right facility can save $3,362+ vs. the state median.
Connecticut Spinal Fusion prices by facility
All prices below come from hospital chargemasters — the official price lists each hospital must publish under federal law. Gross charge is the undiscounted list price; cash price is the self-pay rate; negotiated range covers the spread across insurance contracts.
- Cash price — the self-pay rate you can actually negotiate and pay
- Negotiated rate — if reported by the hospital across insurance contracts
- Gross charge — fallback only; this is the inflated list price few people pay
This reflects the real prices patients encounter — not inflated chargemaster rates.
| # | Facility | City | Your Price | vs Median | Gross Charge |
|---|---|---|---|---|---|
| #1 | Gaylord Hospital Inc | Wallingford, CT | $1,342 | -$3,362 | $1,342–$2,528 |
| #2 | Danbury Hospital | Danbury, CT | $3,001 | -$1,703 | $1,120–$36,429 |
| #3 | Norwalk Hospital | Norwalk, CT | $3,027 | -$1,677 | $1,036–$36,297 |
| #4 | Prospect Waterbury, Inc | Waterbury, CT | $3,863 | -$841 | $1,069–$17,035 |
| #5 | Bristol Hospital, Inc | Bristol, CT | $3,211 | -$1,493 | $1,342–$4,214 |
| #6 | UCONN Health | CT | $3,327 | -$1,377 | $2,748–$22,644 |
| #7 | Sharon Hospital | Po Box 789, CT | $4,523 | -$181 | $1,375–$32,528 |
| #8 | Prospect Manchester Hospital, Inc | Manchester, CT | $4,704 | +$0 | $4,704–$9,717 |
| #9 | Prospect Rockville Hospital, Inc | Vernon Rockville, CT | $4,704 | +$0 | $4,704–$9,717 |
| #10 | Stamford Hospital | Stamford, CT | $4,802 | +$98 | $4,802–$32,528 |
| #11 | HOSPITAL OF CENTRAL CONNECTICUT AT NEW BRITAIN D/B/A THE HOSPITAL OF CENTRAL CONNECTICUT | New Britain, CT | $5,246 | +$542 | $5,246–$100,586 |
| #12 | THE WILLIAM W BACKUS HOSPITAL | Norwich, CT | $5,246 | +$542 | $5,246–$34,574 |
| #13 | WINDHAM COMMUNITY MEMORIAL HOSPITAL INC | Willimantic, CT | $5,246 | +$542 | $5,246–$32,357 |
| #14 | THE CHARLOTTE HUNGERFORD HOSPITAL | Torrington, CT | $5,246 | +$542 | $5,246–$26,375 |
| #15 | MIDSTATE MEDICAL CENTER | Meriden, CT | $5,246 | +$542 | $5,246–$38,563 |
| #16 | HARTFORD HOSPITAL | Hartford, CT | $5,246 | +$542 | $5,246–$97,376 |
| #17 | Griffin Hospital | Derby, CT | $5,823 | +$1,119 | $2,969–$21,984 |
Unlock all 12 remaining Connecticut hospitals
Enter your email to reveal the full table instantly — and we'll email you the complete price list as a PDF to keep.
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Source: CMS hospital price transparency machine-readable files. vs Median = savings or premium relative to the state median price. Gross Charge = undiscounted list price for reference.
Received a bill? Check it for errors → Estimate YOUR cost before you go →
Compare other procedures in Connecticut:
Where you can save the most on spinal fusion in Connecticut
These facilities have the lowest declared prices relative to the state median — they represent the best opportunities to reduce your out-of-pocket cost for this procedure.
| Facility | City | Your Price | vs Median |
|---|---|---|---|
| Gaylord Hospital Inc | Wallingford, CT | $1,342 | -$3,362 |
| Danbury Hospital | Danbury, CT | $3,001 | -$1,703 |
| Norwalk Hospital | Norwalk, CT | $3,027 | -$1,677 |
| Prospect Waterbury, Inc | Waterbury, CT | $3,863 | -$841 |
| Bristol Hospital, Inc | Bristol, CT | $3,211 | -$1,493 |
How to choose a lower-cost facility
- Choose independent outpatient centers when possible — freestanding ASCs (ambulatory surgical centers) consistently charge less than hospital outpatient departments for identical procedures.
- Ask for the cash price if your deductible isn't met — self-pay rates are often lower than what insurance pays before your deductible is satisfied, especially at facilities that have a high cash-price discount.
- Avoid hospital outpatient departments for routine cases — hospital-owned locations add a facility fee that freestanding centers don't charge, often adding $500–$1,500 to the same procedure.
Most expensive spinal fusion providers in Connecticut
These facilities report the highest prices for this procedure. Academic medical centers and specialty hospitals often top this list — their gross charges rarely reflect what anyone actually pays, but understanding the spread helps you negotiate.
| Facility | City | Price | vs Median |
|---|---|---|---|
| Griffin Hospital | Derby, CT | $5,823 | +$1,119 |
| HOSPITAL OF CENTRAL CONNECTICUT AT NEW BRITAIN D/B/A THE HOSPITAL OF CENTRAL CONNECTICUT | New Britain, CT | $5,246 | +$542 |
| THE WILLIAM W BACKUS HOSPITAL | Norwich, CT | $5,246 | +$542 |
| WINDHAM COMMUNITY MEMORIAL HOSPITAL INC | Willimantic, CT | $5,246 | +$542 |
| THE CHARLOTTE HUNGERFORD HOSPITAL | Torrington, CT | $5,246 | +$542 |
Why prices vary this much
A small number of hospitals (1) report very high prices above $8,168, which drives much of the overall price range. Excluding these, most facilities cluster in a significantly tighter band.
Setting drives much of the gap in Connecticut: the median outpatient price is $4,704 versus $3,211 inpatient, so where a procedure is performed often matters more than which hospital you choose. Of the Connecticut facilities reporting prices, 5 fall in a low-cost tier (up to $3,298) while 8 sit in a high-cost tier ($5,246 and up) — a lower-priced option almost always exists within the same state.
Among the cities with the most reporting hospitals, Wallingford has a median reported price of $7,104 across 2 facilities, while facilities in Bristol tend to report lower prices (median: $3,451). City-level variation within a state often reflects local market structure, not procedure complexity.
The spread comes from how each hospital sets its chargemaster (the undiscounted list price), what cash discounts it applies, and what rates it negotiates with each insurer. Facility classification matters too — a hospital-owned outpatient center adds a facility fee that a freestanding clinic does not. Understanding these mechanics is the first step to paying less.
Learn more:
→ Allowed amount vs negotiated rate — what your EOB is really saying
→ How to read your medical bill
→ Why hospital prices are so hard to find — and what to do about it
How insurance changes what you actually pay
Hospital list prices are only part of the picture. What you pay out of pocket depends on your deductible, your plan's out-of-pocket maximum, whether the facility is in-network, and whether your plan classifies the visit as outpatient or inpatient. A lower gross charge doesn't guarantee a lower bill if the facility is out-of-network or adds facility fees your plan doesn't cover.
Understand your cost before you go:
→ Deductible vs out-of-pocket max
→ EOB vs medical bill — complete guide
→ How to stop medical bill problems before they start (in-network vs out-of-network)
Spinal Fusion Costs by Metro Area in Connecticut
Prices vary across Connecticut metro areas based on local hospital competition, wage adjustments, and facility mix. Explore detailed facility price data for each metro area:
- Spinal Fusion Cost in Bridgeport, CT
- Spinal Fusion Cost in Hartford, CT
- Spinal Fusion Cost in New Haven, CT
Compare spinal fusion costs in nearby states
Frequently asked questions: spinal fusion costs in Connecticut
How much does a spinal fusion cost in Connecticut?
Across 17 Connecticut hospitals that publish prices, a spinal fusion ranges from $1,036 to $100,586, with a median of $4,704. Most facilities fall between $3,298 and $5,246. What you pay depends on the facility, your insurance, and whether you have met your deductible.
Where is the cheapest place to get a spinal fusion in Connecticut?
Based on declared prices, the lowest-cost facility in our Connecticut data is Gaylord Hospital Inc in Wallingford at about $1,342. By metro, Bristol has the lowest median ($3,451). Freestanding ambulatory surgery and imaging centers are often cheaper still and may not appear in hospital price data — ask your doctor whether one is an option.
Why is a spinal fusion so much cheaper at some Connecticut hospitals?
Prices vary up to 97.1× because each hospital sets its own list price, cash discount, and insurer-negotiated rates. In Connecticut, the median cash (self-pay) price is $4,704 versus a median negotiated rate of $4,198 — about 1.1× higher. Asking for the cash price or your insurer's negotiated rate is often the single biggest lever on what you pay.
How much will I actually pay out of pocket for a spinal fusion in Connecticut?
Your out-of-pocket cost depends on your deductible, coinsurance, out-of-pocket maximum, and whether the facility is in-network — not just the sticker price. If you have not met your deductible, you will typically pay the negotiated rate in full until you do. Use the CostKits cost forecaster to estimate your specific out-of-pocket amount before you go.
Explore all spinal fusion cost data
→ See spinal fusion costs across all states
Other Connecticut Hospitals for Spinal Fusion
These hospitals are registered in the CMS National Provider Identifier (NPI) registry as active hospitals in Connecticut. Cost estimates use the bundled service model for each place of service. Contact them directly for a formal quote.
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23 FAIR STREET OPERATIONS LLC
8605892923 |
BRISTOL, CT | Long Term Care Hospital | $1,911–$20,650 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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APC SURGICAL, LLC
2039123396 |
STAMFORD, CT | General Acute Care Hospital | $1,911–$20,650 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BRADLEY MEMORIAL HOSPITAL AND HEALTH CENTER
8602768326 |
SOUTHINGTON, CT | General Acute Care Hospital | $1,911–$20,650 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BRIDGEPORT HOSPITAL
2038764000 |
MILFORD, CT | General Acute Care Hospital | $1,911–$20,650 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BRIDGEPORT HOSPITAL
2033843775 |
BRIDGEPORT, CT | General Acute Care Hospital | $1,911–$20,650 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BRIDGEPORT HOSPITAL
2038764000 |
MILFORD, CT | General Acute Care Hospital | $1,911–$20,650 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BRIDGEPORT HOSPITAL
2036882046 |
BRIDGEPORT, CT | General Acute Care Hospital | $1,911–$20,650 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BRIDGEPORT HOSPITAL
2033843446 |
BRIDGEPORT, CT | General Acute Care Hospital | $1,911–$20,650 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BRIDGEPORT HOSPITAL
2033843232 |
BRIDGEPORT, CT | General Acute Care Hospital | $1,911–$20,650 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BRIDGEPORT HOSPITAL
2033843233 |
BRIDGEPORT, CT | Women's Hospital | $1,911–$20,650 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BRIDGEPORT HOSPITAL
2033843792 |
BRIDGEPORT, CT | General Acute Care Hospital | $1,911–$20,650 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BRIDGEPORT HOSPITAL/YALE NEW HAVEN HEALTH
3136329014 |
BRIDGEPORT, CT | General Acute Care Hospital | $1,911–$20,650 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Est. cost = bundled estimate (facility fee + professional fee + anesthesia where applicable) based on CMS fee schedules and commercial rate multipliers. Contact each provider for an actual quote.
Source: CMS NPPES NPI Registry. NPI numbers can be verified at npiregistry.cms.hhs.gov.
What's Actually on Your Spinal Fusion Bill
A spinal fusion involves multiple providers — each bills separately. Understanding each line item helps you verify your Explanation of Benefits and catch billing errors.
Hospital Inpatient
- Drg Facility Stay — DRG 451 (lumbar single-level, no MCC) or DRG 472 (cervical ACDF with CC) used as article defaults. Full DRG tree is complex.
- Spine Surgeon Professional Fee
- Anesthesia
- Implant Hardware Cost — Screws, rods, cages, bone graft. Hardware adds $5,000–$30,000+ depending on number of levels and approach.
- Neuromonitoring (conditional) — Intraoperative neurophysiologic monitoring is common for complex fusions. Billed by a separate technician/neurologist.
Spinal Fusion Cost by Type
Which type your doctor orders changes the billing code — and what you pay. Here's how the common types differ.
Lumbar Spinal Fusion (Single Level)
A recognized variation that can change the billing code and what you owe. Most common. L4-L5 or L5-S1. Lower cost.
Cervical ACDF (Anterior Cervical Discectomy and Fusion)
A recognized variation that can change the billing code and what you owe. Neck fusion approach. ACDF is the most common cervical spine surgery.
Multi-Level Fusion
A recognized variation that can change the billing code and what you owe. 2+ vertebral levels. Significantly higher hardware cost and complexity.
Prior Authorization Is Usually Required
Most commercial and Medicare Advantage plans require pre-approval for spinal fusion before scheduling. If your doctor submits the order without prior authorization — or if the authorization lapses — your insurer can deny the entire claim, leaving you responsible for the full cost.
Action step: Call the member services number on your insurance card before scheduling. Ask: "Does this procedure require prior authorization?" Get the authorization number in writing and confirm it's attached to the claim before your appointment.
Watch for Separate Bills from These Providers
A spinal fusion involves multiple providers: the facility, the operating physician, and often Anesthesia. These providers bill independently — and each one may or may not be in your network, even if the facility is.
Action step: Before your procedure, ask the facility coordinator to confirm that all participating providers are in-network on your plan. The No Surprises Act (2022) protects you from unexpected out-of-network bills in many scenarios — but not all. Request a Good Faith Estimate (GFE) if you ask for one.
The Implant Is the Largest Cost Driver
For spinal fusion, the implant or device typically accounts for 40–70% of the total hospital bill. Surgeons have preferred device relationships that affect which implant is used — and different implants can vary by $5,000–$15,000 in cost.
What to ask: Request an itemized estimate that breaks out the implant separately. Ask your surgeon whether a comparable implant is available at a lower cost.
Who performs this: Spinal Fusion is typically performed by a Orthopedic Surgery (Spine) or Neurosurgery. The specialist's professional fee is billed separately from the facility charge — you will likely receive separate bills from each.
CostKits compiles hospital price transparency data to help families make informed decisions. If you've received a bill for this procedure:
→ Analyze your medical bill for errors
→ How to negotiate your medical bills
→ Track and manage your healthcare costs (free account)
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About the Author
John Caruso, FSA, MAAA
Healthcare actuary with 20+ years of experience in insurance pricing, medical billing systems, and healthcare cost analytics.
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