CMS Price Transparency Data

Colorectal cancer screening (alternative)

Facility: Eastern State Hospital

Billing Code: G0145 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0145
Insurance Median: $1,144
Cash Discount Price: $32
vs. Medicare Baseline: 43.19x Medicare

The contracted insurance negotiated median rate for a Colorectal cancer screening (alternative) at Eastern State Hospital is $1,144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $26.49, this hospital’s rate is 43.19x the Medicare baseline. Located in 1350 Bull Lea Road, Lexington, KY.

Cash / Self-Pay

$32

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,144

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$26.49

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $26.49 (100%)

Cash / Self-Pay: $32 (121%)

Insurance Median: $1,144 (4319%)

Cash: $32 (121% of Medicare)

Ins. Median: $1,144 (4319% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $26.49 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 4319% of the Medicare baseline (a markup of 4219%). 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
Blue Cross Blue Shield	$473	1786%
UnitedHealthcare	$1,053 - $1,144	3975%
United_Healthcare	$1,053	3975%
United_Behavioral_Health	$1,053	3975%
Humana	$1,144	4319%
Medicaid / KanCare	$1,144	4319%
Wellcare	$1,144	4319%
Molina	$1,144	4319%
Aetna	$1,144	4319%

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 $32.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0145.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Eastern State Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0145.
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.