Self-funded employer health plans pay healthcare claims directly from employer assets rather than through traditional insurance. For spine surgery specifically, self-funded plans contracting with bundled-price providers like Synergy can reduce costs substantially compared to traditional hospital-billed care — typically benefiting both the employer and the employee.
How self-funded plans work
Most large employers offer self-funded health plans (technically called ERISA plans). Instead of paying premiums to an insurer who then pays claims, the employer pays claims directly from company assets. A third-party administrator (TPA) handles claim processing, network management, and routine plan administration.The economics differ from traditional insurance. The employer bears the direct cost of claims and benefits from any cost reduction. For high-cost procedures like spine surgery, the difference between hospital-billed costs and bundled-price alternatives can be substantial.
Where Synergy fits
Synergy’s bundled cash prices represent a substantial cost reduction compared to typical hospital-billed spine surgery. Self-funded employers can contract directly with Synergy to access these prices for their plan members. The employee gets care at a high-quality facility; the plan pays substantially less than it would for hospital-billed equivalent.The contracting structure typically involves a center of excellence designation, a direct contract with the plan, and sometimes additional benefits for plan members who use the contracted provider (waived or reduced cost-sharing, covered travel, etc.).
Benefits to plan members
For employees of self-funded employers contracting with Synergy: high-quality spine care at a contracted facility, often with reduced or eliminated out-of-pocket expense, sometimes with covered travel costs. The plan typically structures benefits to encourage use of the contracted provider when clinically appropriate.The patient experience is comparable to or better than traditional in-network care: transparent pricing, no surprise bills, coordinated travel and accommodations when needed.
Send your MRI for a free review
Dr. McMillan reviews each scan personally. You get a candid answer about candidacy before any travel or scheduling.
What we suggest doing first
If you are weighing this decision, the most useful single action is sending your MRI for a free review. The review costs nothing and produces a candid written assessment from Dr. McMillan — including the answer that you are not a candidate, when that is the honest answer. We do not ask patients to travel for a procedure that will not help them.
When the review indicates that the endoscopic approach fits, the next step is a $250 consultation. The fee covers Dr. McMillan’s time to review the imaging in detail and discuss what the procedure would involve for your specific situation. If you decide to proceed, the $250 is credited toward the procedure bundle. If you decide not to proceed, you owe the consultation fee and nothing further.
From there, scheduling moves at a pace that fits your situation. The procedure is outpatient, takes about an hour, and most patients are home the same day. Post-procedure follow-up is part of the bundle. For patients coming from out of town, the office coordinates lodging guidance, transportation considerations, and handoff with your local providers — this is a routine part of how we work, not an exception. The goal throughout is to make a complicated decision more navigable, with the actual numbers and the actual options in front of you.
How to evaluate fit
Self-funded employers evaluating direct contracting consider: plan member demographics and likely procedure utilization, total spine-related claim costs over recent years, travel logistics for plan members, and quality metrics for potential contracted providers.The math typically favors direct contracting when: spine procedure utilization is non-trivial, hospital-billed costs in the plan’s region are substantial, plan members are willing to travel for procedures, and quality metrics at the contracted provider are strong. For many large self-funded plans, all of these conditions hold.
Bottom line
Self-funded employer health plans pay healthcare claims directly from employer assets rather than through traditional insurance. For spine surgery specifically, self-funded plans contracting with bundled-price providers like Synergy can reduce costs substantially compared to traditional hospital-billed care — typically benefiting both the employer and the employee.
If you’ve been told you need a fusion — or you’re trying to avoid one — a free MRI review is the most useful next step. Dr. McMillan reviews each scan personally and tells you candidly whether the endoscopic approach fits your specific anatomy.
For patients dealing with self funded employer spine surgery, the conversation comes down to specifics: what your imaging actually shows, what your symptoms are actually telling us, and which procedure (if any) genuinely matches that pattern. The candid answer is sometimes that you do not need surgery yet; the candid answer is sometimes that you do, but a smaller operation than the one you have been quoted. A second-opinion MRI review separates those cases and gives you the information you need to make the decision well.
How Synergy structures pricing — and why it matters for self-funded employer spine surgery
The pricing model at Synergy Spine Center exists because the U.S. spine surgery market historically operates without it. A patient quoted “between $80,000 and $150,000” for a fusion by a hospital surgeon learns the actual number — surgeon, facility, anesthesia, implants, post-op — only after surgery, often via four or five separate invoices arriving over six months. Synergy publishes its 2026 procedural rates on the site at /spine-surgery-cost-transparent-pricing/ precisely so patients can plan financially before scheduling.
For patients researching self-funded employer spine surgery specifically, the practical implication is that the price you see at the point of endoscopic discectomy consultation is the price you pay. Bundled cash pricing covers surgeon time, facility use, anesthesia, and routine post-operative follow-up. There are no separate invoices from the anesthesiologist, no facility fee added by a hospital, and no surprise billing from out-of-network providers because the practice does not contract with any out-of-network providers as part of routine procedures. For comparison context, the transparent spine surgery pricing page covers how this approach fits the broader pricing picture across spine surgery.
Financial planning begins with the free MRI review, which establishes candidacy before any financial commitment. Patients who are candidates receive a written assessment that includes the specific procedure recommended and the corresponding bundled price. Patients who are not candidates are told that directly, with referral guidance — the review is screening, not sales. Out-of-town patients should also review the 3-day plan and medical travel cost page to estimate total trip expenses. For broader background on healthcare price transparency policy, U.S. DOL — ERISA provides regulatory and consumer guidance.
Frequently asked
How is this different from regular insurance?
Self-funded plans pay claims directly; traditional insurance pays through premium collections. The economics differ — self-funded plans capture cost savings directly. For a personalized price quote tied to your specific diagnosis, submit your imaging through the free MRI review — you’ll receive the bundled price for the specific recommended procedure along with candidacy assessment.
Is my employer self-funded?
Most large employers (typically 200+ employees) use self-funded structures. Your HR department can confirm. Detailed price information for the most relevant procedure is at the endoscopic discectomy page, where 2026 bundled rates are published openly.
Can my plan contract with Synergy?
Plans interested in direct contracting typically work through their TPA or benefits consultant. Synergy works with multiple self-funded employer plans. For a personalized price quote tied to your specific diagnosis, submit your imaging through the free MRI review — you’ll receive the bundled price for the specific recommended procedure along with candidacy assessment.
Will my out-of-pocket be different?
Plan-specific. Direct contracting often involves reduced or waived patient cost-sharing as part of the structure. Detailed price information for the most relevant procedure is at the endoscopic discectomy page, where 2026 bundled rates are published openly.
Does this work for COOLIEF too?
Direct contracting can cover any procedure Synergy offers, including COOLIEF. The structure adapts to the plan’s needs. Detailed price information for the most relevant procedure is at the endoscopic discectomy page, where 2026 bundled rates are published openly.
Is travel included?
Often yes for plan members coming from out of region. Plan-specific. Out-of-town patients should also review the 3-day plan and the medical travel cost page to estimate full trip cost beyond the procedural fee.
How this page was prepared
This page summarizes the clinical approach taken at Synergy Spine Center for the topic above. It is based on peer-reviewed literature, professional society guidelines (NASS, AAOS), federal patient education resources (NIH, AHRQ, CMS), and Dr. McMillan’s experience as Director of Spinal Medicine and Endoscopic Spinal Surgery. Outcome language is qualified. Individual results vary. Pricing where shown is current for 2026 and may change.
References
- CMS — self-funded plan regulation. — source
- PubMed — bundled payment outcomes. — source
- NASS — employer-direct contracting resources. — source
- U.S. DOL — ERISA — authoritative reference on self-funded employer spine surgery.
- KFF — Health Costs Research — authoritative reference on self-funded employer spine surgery.
Synergy Spine Center publishes patient education content for general information only; it is not medical advice and does not establish a physician-patient relationship. For specific medical guidance, schedule a consultation. No identifiable patient information is included on this page.