CMS Price Transparency Data

Drug screening test

Facility: Jacobson Memorial Hospital Care Center

Billing Code: G0480 (HCPCS)

The BaseRate · fair price medium confidence
A fair price for this
$202
about 1.8× the $114 Medicare rate · typically $75–$413
modeled estimate · not a bill or quote
Medicare pays $114 Fair price $202 Cash price $567 Hospital's list price $756

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $576 - $756 503%
Blue Cross Blue Shieldmajor $756 - $1,058 661%
Aetnamajor $454 - $756 397%
Cignamajor $680 594%
Humanamajor $756 661%
HealthPartners $680 594%
Medica $605 529%
Sanford Health Plan $756 661%
+ 2 smaller / regional plans $605 - $756
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

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A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: 601 East St N, Elgin, ND 58533
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals