CMS Price Transparency Data

Diagnostic procedure preparation

Facility: Gadsden Regional Medical Center

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0279
Insurance Median: $434
Cash Discount Price: $108
vs. Medicare Baseline: 10.74x Medicare

The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Gadsden Regional Medical Center is $434. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 10.74x the Medicare baseline. Located in 1007 Goodyear Avenue, Gadsden, AL.

Cash / Self-Pay

$108

Average discount available for prompt cash payment at this facility.

Insurance Median

$434

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$40.41

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $40.41 (100%)

Cash / Self-Pay: $108 (267%)

Insurance Median: $434 (1074%)

Cash: $108 (267% of Medicare)

Ins. Median: $434 (1074% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $40.41 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1074% of the Medicare baseline (a markup of 974%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Abccedp	$11	27%
Veterans Eval Services	$13	32%
Node Champva	$13	32%
Tricare	$13	32%
UnitedHealthcare	$51	126%
Self Pay	$87 - $130	215%
American Employee Alliance	$289	715%
Aetna	$374	926%
Multiplan	$405 - $455	1002%
Magellan Behavioral	$434	1074%
Viva Healthcare	$434	1074%
First Health	$506 - $584	1252%
Prime Health	$506 - $522	1252%
Beech Street	$528 - $1,525	1307%
Alamed Wc	$542	1341%
Focus Health	$553	1368%
Coventry Work Comp Al	$565	1398%
Work Comp	$614	1519%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $108.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0279.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Gadsden Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0279.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.