CMS Price Transparency Data

Drug screening test

Facility: Southcoast Hospitals Group

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0480
Insurance Median: $128
Cash Discount Price: $205
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Drug screening test at Southcoast Hospitals Group is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $205. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 1.12x the Medicare baseline. Located in 363 Highland Avenue, Fall River, MA.

Cash / Self-Pay

$205

Average discount available for prompt cash payment at this facility.

Insurance Median

$128

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: $205 (179%)

Insurance Median: $128 (112%)

Cash: $205 (179% of Medicare)

Ins. Median: $128 (112% 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.

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 Health Public Plans [1010213]	$61	53%
Wellsense Health Plan Clarity Connectorcare & Meta	$88	77%
Medicare (plans)	$101 - $137	88%
Aetna	$114 - $291	100%
Blue Cross Blue Shield	$114 - $182	100%
Evercare [1010304]	$114	100%
Tufts Senior Care Options [1010315]	$114	100%
UnitedHealthcare	$114 - $137	100%
Wellsense Health Plan Senior Care Options [1020208	$116	101%
Commonwealth Care Alliance [1080501]	$118 - $119	103%
Eternal Health [1010322]	$126	110%
Fallon [1000114]	$160	140%
Tufts [1010701]	$171	149%
Harvard Pilgrim [1010602]	$217	190%
Mass General Brigham Health Plan Commercial [10122	$231	202%
Mass General Brigham Health Plan Connectorcare [10	$231	202%
Group Insurance Service Center [1013001]	$246	215%
Innovative Health Plan [1025001]	$246	215%
Priority Health [1015001]	$246	215%
Cigna	$260	227%
PHCS [1000125]	$266	232%
Wellpoint [1000102]	$267	233%
First Health [1000130]	$291	254%

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 $205.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0480.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Southcoast Hospitals Group is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0480.
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.