CMS Price Transparency Data

Injection procedure for pain management

Facility: Boston Medical Center

Billing Code: G0260 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0260
Insurance Median: $820
Cash Discount Price: $843
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Injection procedure for pain management at Boston Medical Center is $820. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $843. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 1.14x the Medicare baseline. Located in 1 Boston Medical Center Place, Boston, MA.

Cash / Self-Pay

$843

Average discount available for prompt cash payment at this facility.

Insurance Median

$820

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$721.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $721.17 (100%)

Cash / Self-Pay: $843 (117%)

Insurance Median: $820 (114%)

Cash: $843 (117% of Medicare)

Ins. Median: $820 (114% of 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.

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
Tufts Conncare/Qhp [8020]	$431 - $1,165	60%
Hsn Bad Debt [4003]	$513	71%
Hsn Confidential [4007]	$513	71%
Hsn [4001]	$513	71%
Hsn Dental [4006]	$513	71%
Hsn Partial [4002]	$513	71%
United [2025]	$599 - $2,015	83%
Harvard Pilgrim Health Care [8001]	$599	83%
Zzzhealth Plans Inc [1013]	$599	83%
Zzzunited [1008]	$599 - $2,015	83%
Health Plans Inc [2027]	$599	83%
Medicaid / KanCare	$675	94%
Blue Cross Blue Shield	$685 - $820	95%
UnitedHealthcare	$695 - $2,015	96%
Uphams Corner Esp [1213]	$750	104%
Tricare	$781	108%
Champva [9004]	$781	108%
Tufts [8002]	$802 - $1,873	111%
Workers Comp [5002]	$803	111%
Zzzcity of Boston Work Comp [5003]	$803	111%
Zzzbu Employee Work Comp [5004]	$803	111%
Veterans Admin [9003]	$820	114%
Humana	$820	114%
Ubh Hphc [8016]	$820	114%
Medicare (plans)	$820 - $861	114%
Aetna	$820 - $916	114%
Neighborhood Pace [1206]	$820	114%
Zzzcovid19 Hrsa Uninsured Testing and Treatment Fund [500010]	$820	114%
Wellcare [1240]	$853	118%
Cca [1215]	$861	119%
Corrections [9001]	$861 - $1,025	119%
Zzzcca Onecare [1216]	$861	119%
Eternalhealth [1227]	$869	120%
Fallon Sco [1126]	$902	125%
Meritain Health [1023]	$916	127%
Senior Whole Health [1210]	$984	136%
Mass General Brigham Health Plan Commercial [8009]	$1,011	140%
Fallon [8008]	$1,066	148%
Unicare [8004]	$1,406	195%
Wellpoint [2034]	$1,406	195%
Cigna	$1,593 - $1,873	221%
Oxford Health [1007]	$2,015	279%
Oxford Health [2024]	$2,015	279%

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 $843.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0260.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Boston Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0260.
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.