CMS Price Transparency Data

Drug screening test

Facility: Mary Hitchcock Memorial Hospital

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0480
Insurance Median: $118
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Drug screening test at Mary Hitchcock Memorial Hospital is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 1.03x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$118

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%)

Insurance Median: $118 (103%)

Ins. Median: $118 (103% 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
UnitedHealthcare	$48 - $458	42%
Amerihealth Caritas Nh	$51 - $54	45%
Granite State Health Plan	$51 - $56	45%
Beacon Health Strategies/Carelon	$51 - $53	45%
Wellsense Health Plan	$51 - $120	45%
Harvard Pilgrim Health Care of Ne	$74 - $551	65%
Blue Cross Blue Shield	$74 - $544	65%
Cigna	$97 - $118	85%
Martin's Point Generations Advantage	$114	100%
Mvp	$114 - $117	100%
Martin's Point Health Care	$118	103%
Aetna	$118	103%
Wellcare Health Plans	$119	104%
Ambetter / Centene	$120 - $376	105%
Mass General Brigham Health Plan	$224	196%
Tufts Health Plan	$331 - $420	289%

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 $X.
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 Mary Hitchcock Memorial Hospital 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.