CMS Price Transparency Data

Drug screening test

Facility: St Joseph's Hospital

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0480
  • Insurance Median: $223
  • Cash Discount Price: $174
  • vs. Medicare Baseline: 1.95x Medicare
The contracted insurance negotiated median rate for a Drug screening test at St Joseph's Hospital is $223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 1.95x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$174

Average discount available for prompt cash payment at this facility.

Insurance Median
$223

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$114.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $114.43 (100%)
Cash / Self-Pay: $174 (152%)
Insurance Median: $223 (195%)
Cash: $174 (152% of Medicare)
Ins. Median: $223 (195% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $114.43 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.

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
Sae Hospice $48 - $241 42%
Molina Healthcare $48 - $241 42%
Blue Cross Blue Shield $48 - $241 42%
Aetna $48 - $241 42%
Humana $48 - $241 42%
Clear Spring Health of Illinois $48 - $241 42%
UnitedHealthcare $48 - $241 42%
Amish Community $67 59%
Naphcare $101 - $506 88%
Celtic Insurance Company $106 - $241 93%
Hopetrust $120 - $241 105%
Claim Doc $120 - $602 105%
Meridian Health Plan $120 105%
Wellfirst $154 135%
First Health $178 156%
Healthlink $205 179%
Multiplan/Phcs $205 179%
Provider Network of America $217 190%
Healthcare Finest Network (Hfn) $217 190%
Caterpillar, Inc. $229 200%
Qtc Medical Group of Illinois $241 211%
Health Alliance Medical Plans $241 211%
Mental Health Network $241 211%
Cigna $241 211%
Interplan $241 211%
Consociate Group $241 211%
Illinois Breast and Cervical Cancer Program $241 211%
Current Health Solutions $241 211%
Healthscope $241 211%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals