CMS Price Transparency Data

Drug screening test

Facility: Frisbie Memorial Hospital

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0480
Insurance Median: $221
Cash Discount Price: $559
vs. Medicare Baseline: 1.93x Medicare

The contracted insurance negotiated median rate for a Drug screening test at Frisbie Memorial Hospital is $221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $559. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 1.93x the Medicare baseline. Located in 11 Whitehall Road, Rochester, NH.

Cash / Self-Pay

$559

Average discount available for prompt cash payment at this facility.

Insurance Median

$221

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: $559 (489%)

Insurance Median: $221 (193%)

Cash: $559 (489% of Medicare)

Ins. Median: $221 (193% 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
Amerihealth Caritas	$54	47%
Well Sense Health Plan	$55	48%
Harvard Pilgrim	$101 - $385	88%
Maine Community Health	$109 - $459	95%
Aetna	$114 - $549	100%
Blue Cross Blue Shield	$114 - $480	100%
Humana	$114 - $115	100%
United VA Ccn	$114	100%
Cigna	$117 - $2,514	102%
Evernorth Behavioral Health	$117	102%
United	$117 - $573	102%
Martin's Point Health	$118 - $119	103%
Tufts Health Plan	$131 - $543	114%
Ambetter / Centene	$204	178%
Evernorth	$306 - $760	267%

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 $559.
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 Frisbie 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.