Insertion of cage or mesh device in disc space during spine fusion
Medicare pricing data for 2,373 providers across 40 states
This procedure has a 8.2x markup — hospitals charge $1,863 but Medicare allows only $228.50. Uninsured patients may face bills 8.2 times higher than what insurance negotiates. Prices vary significantly by location — from $121 in Alabama to $356 in District of Columbia. Where you get this procedure matters more than almost any other factor. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Insertion of cage or mesh device in disc space during spine fusion (HCPCS code 22854) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $228.50, but hospitals typically charge $1,863 — a 8.2x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $228.50, your out-of-pocket cost would be approximately $45.70. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 8.2x more than what Medicare allows for this procedure. Medicare actually pays $182.38 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $356 | $1,252 | 6 | 24 | +56.0% |
| New Mexico | $334 | $1,555 | 3 | 13 | +46.2% |
| Massachusetts | $290 | $1,948 | 48 | 88 | +26.9% |
| Maryland | $270 | $1,033 | 55 | 186 | +18.2% |
| Rhode Island | $269 | $1,438 | 10 | 16 | +17.7% |
| Illinois | $269 | $1,415 | 68 | 123 | +17.5% |
| Virginia | $262 | $1,254 | 63 | 147 | +14.6% |
| New York | $258 | $2,647 | 104 | 234 | +12.9% |
| Kentucky | $257 | $1,015 | 43 | 108 | +12.6% |
| Michigan | $254 | $1,877 | 94 | 199 | +10.9% |
| Mississippi | $253 | $1,896 | 17 | 32 | +10.7% |
| Florida | $243 | $1,921 | 212 | 707 | +6.2% |
| New Jersey | $237 | $6,977 | 50 | 101 | +3.7% |
| California | $236 | $1,787 | 214 | 1,068 | +3.1% |
| Missouri | $234 | $1,126 | 52 | 81 | +2.3% |
| Ohio | $232 | $1,045 | 95 | 164 | +1.6% |
| Connecticut | $230 | $1,511 | 35 | 56 | +0.9% |
| Texas | $230 | $2,185 | 205 | 694 | +0.7% |
| Washington | $227 | $806 | 54 | 84 | -0.6% |
| Pennsylvania | $224 | $1,240 | 74 | 139 | -2.1% |
| Tennessee | $224 | $879 | 54 | 178 | -2.2% |
| Utah | $222 | $959 | 17 | 30 | -2.9% |
| North Carolina | $220 | $1,001 | 89 | 177 | -3.7% |
| Indiana | $217 | $1,055 | 34 | 69 | -4.9% |
| Kansas | $215 | $917 | 20 | 32 | -5.8% |
| Georgia | $213 | $1,062 | 71 | 151 | -6.8% |
| Wisconsin | $211 | $4,158 | 34 | 62 | -7.6% |
| Colorado | $209 | $844 | 71 | 174 | -8.5% |
| New Hampshire | $208 | $2,857 | 10 | 16 | -9.1% |
| Louisiana | $206 | $1,789 | 53 | 190 | -9.7% |
| Oregon | $203 | $709 | 12 | 17 | -11.1% |
| Nevada | $202 | $7,049 | 32 | 263 | -11.8% |
| Minnesota | $201 | $1,190 | 53 | 122 | -12.0% |
| Arizona | $200 | $960 | 55 | 159 | -12.4% |
| Oklahoma | $199 | $730 | 38 | 86 | -12.8% |
| Arkansas | $194 | $952 | 25 | 76 | -15.0% |
| South Carolina | $194 | $934 | 54 | 254 | -15.0% |
| Nebraska | $188 | $1,016 | 10 | 23 | -17.9% |
| Idaho | $166 | $1,778 | 24 | 52 | -27.4% |
| Alabama | $121 | $834 | 46 | 134 | -47.1% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber