CMS Price Transparency Data

Diagnostic procedure preparation

Facility: Mary Hitchcock Memorial Hospital

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0279
Insurance Median: $42
Cash Discount Price: $19
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Mary Hitchcock Memorial Hospital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.04x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

$19

Average discount available for prompt cash payment at this facility.

Insurance Median

$42

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$40.41

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $40.41 (100%)

Cash / Self-Pay: $19 (47%)

Insurance Median: $42 (104%)

Cash: $19 (47% of Medicare)

Ins. Median: $42 (104% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $40.41 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
Wellsense Health Plan	$7 - $92	17%
Granite State Health Plan	$7 - $107	17%
Beacon Health Strategies/Carelon	$7 - $101	17%
Amerihealth Caritas Nh	$7 - $104	17%
Harvard Pilgrim Health Care of Ne	$10 - $63	25%
Aetna	$16 - $46	40%
Martin's Point Generations Advantage	$16 - $43	40%
Blue Cross Blue Shield	$16 - $156	40%
UnitedHealthcare	$16 - $102	40%
Wellcare Health Plans	$16 - $45	40%
Cigna	$16 - $45	40%
Ambetter / Centene	$16 - $93	40%
Mvp	$16 - $94	40%
Martin's Point Health Care	$20 - $48	49%
Tufts Health Plan	$33 - $117	82%
Mass General Brigham Health Plan	$33 - $80	82%
Maine Community Health Options	$37 - $49	92%
First Health/Hcvm	$50 - $57	124%
Coventry	$50 - $57	124%
PHCS	$52 - $59	129%
Corvel	$53 - $61	131%
Ccmsi	$55 - $63	136%

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 $19.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0279.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mary Hitchcock Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0279.
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.