CMS Price Transparency Data

Diagnostic procedure preparation

Facility: Frisbie Memorial Hospital

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0279
Insurance Median: $32
Cash Discount Price: $55
vs. Medicare Baseline: 0.79x Medicare

The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Frisbie Memorial Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 0.79x the Medicare baseline. Located in 11 Whitehall Road, Rochester, NH.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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: $55 (136%)

Insurance Median: $32 (79%)

Cash: $55 (136% of Medicare)

Ins. Median: $32 (79% 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
Amerihealth Caritas	$5	12%
Well Sense Health Plan	$7	17%
Aetna	$13 - $32	32%
Blue Cross Blue Shield	$13 - $250	32%
Cigna	$13 - $854	32%
Evernorth Behavioral Health	$13	32%
Humana	$13 - $15	32%
United	$13 - $33	32%
United VA Ccn	$13	32%
Martin's Point Health	$14 - $16	35%
Maine Community Health	$16 - $27	40%
Tufts Health Plan	$19 - $31	47%
Ambetter / Centene	$24	59%
Evernorth	$44	109%

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 $55.
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 Frisbie 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.