Injection procedure for pain management
Facility: Johnson Memorial Hospital
Billing Code: G0260 (HCPCS)
- CPT Billing Code: G0260
- Insurance Median: $3,813
- Cash Discount Price: $2,461
- vs. Medicare Baseline: 5.29x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $721.17 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 529% of the Medicare baseline (a markup of 429%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Fallon Health | $101 | 14% |
| Innovative Health Plan II | $162 | 22% |
| Diversified Administrators | $162 | 22% |
| Claimdoc | $162 | 22% |
| Centivo | $180 | 25% |
| Aetna | $829 | 115% |
| UnitedHealthcare | $829 - $5,719 | 115% |
| Medicare (plans) | $829 - $872 | 115% |
| Blue Cross Blue Shield | $829 - $6,585 | 115% |
| Cca Senior Care Options | $846 | 117% |
| Cigna | $854 - $4,461 | 118% |
| Health New England | $2,478 - $3,717 | 344% |
| Prime Health Services | $3,050 - $4,575 | 423% |
| Ghc Scw | $3,165 - $4,747 | 439% |
| Asrm - Reliance Standard Life Insurance | $3,165 - $4,747 | 439% |
| Mvp | $3,165 - $4,747 | 439% |
| Pai | $3,165 - $4,747 | 439% |
| PHCS | $3,165 - $4,747 | 439% |
| Medi Share | $3,165 - $4,747 | 439% |
| Christian Care Ministry | $3,165 - $4,747 | 439% |
| Allied National Global Care | $3,165 - $4,747 | 439% |
| Pan-American Life | $3,165 - $4,747 | 439% |
| Lifetime Benefit Solutions | $3,165 - $4,747 | 439% |
| Dean Health | $3,165 - $4,747 | 439% |
| Family Life Insurance Company | $3,165 - $4,747 | 439% |
| Trinity Health Share | $3,165 - $4,747 | 439% |
| Paramount HMO | $3,165 - $4,747 | 439% |
| Manhattan Life | $3,165 - $4,747 | 439% |
| International Benefit Administrators | $3,165 - $4,747 | 439% |
| Multiplan | $3,165 - $4,747 | 439% |
| Health Smart | $3,241 - $4,861 | 449% |
| United Behavioral Health Eap | $3,813 - $5,719 | 529% |
| Pre-Employment | $6,585 | 913% |
| Blue Shield - Ca | $6,585 | 913% |
| Blue Care Network | $6,585 | 913% |
| Blue Benefit Administrators of Massachusetts | $6,585 | 913% |
| Blue Distinction Transplant | $6,585 | 913% |
| Blue Shield - PA (Highmark) | $6,585 | 913% |
| Bcn Domestic | $6,585 | 913% |
| Blue Shield - Ny Highmark Northeastern | $6,585 | 913% |
| Wellpoint | $6,585 | 913% |
| Wc Domestic | $6,585 | 913% |
| Blue Shield - Id (Regence) | $6,585 | 913% |
| Blue Shield - Wa (Regence) | $6,585 | 913% |
| Kaiser Domestic | $6,585 | 913% |
| Blue Shield - Ny Highmark Western | $6,585 | 913% |
| Health Choices | $6,585 | 913% |
| Unicare | $6,585 | 913% |