CMS Price Transparency Data

Colorectal cancer screening

Facility: Kootenai Health

Billing Code: G0010 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0010
Insurance Median: $49
Cash Discount Price: $54
vs. Medicare Baseline: 1.02x Medicare

The contracted insurance negotiated median rate for a Colorectal cancer screening at Kootenai Health is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.02x the Medicare baseline. Located in 2003 Kootenai Health Way, Coeur D'Alene, ID.

Cash / Self-Pay

$54

Average discount available for prompt cash payment at this facility.

Insurance Median

$49

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$47.84

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $47.84 (100%)

Cash / Self-Pay: $54 (113%)

Insurance Median: $49 (102%)

Cash: $54 (113% of Medicare)

Ins. Median: $49 (102% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $47.84 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.

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
Coordinated Care of Washington	$8	17%
Molina Healthcare of Idaho	$8 - $50	17%
Molina Healthcare of Washington	$8	17%
Magellan	$17	36%
Wellpoint	$17	36%
UnitedHealthcare	$24 - $65	50%
Aetna	$27 - $60	56%
Premera	$44 - $48	92%
Regence Blue Shield of Idaho	$45 - $48	94%
Humana	$48	100%
Pacificsource	$49 - $59	102%
Blue Cross Blue Shield	$49 - $65	102%
Mountain Health Co-Op	$56	117%
Cigna	$59 - $60	123%
Interwest Health	$61	128%
First Choice Health (Ameriben)	$61 - $62	128%
Group Health/Kaiser	$174	364%

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 $54.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0010.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Kootenai Health is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0010.
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.