CMS Price Transparency Data

Diagnostic procedure preparation

Facility: Cheshire Medical Center

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0279
Insurance Median: $43
Cash Discount Price: $44
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Cheshire Medical Center is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.06x the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$44

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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: $44 (109%)

Insurance Median: $43 (106%)

Cash: $44 (109% of Medicare)

Ins. Median: $43 (106% 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 Nh	$7 - $32	17%
Wellsense Health Plan	$8 - $46	20%
Granite State Health Plan	$10 - $43	25%
Harvard Pilgrim Health Care of Ne	$12 - $118	30%
Aetna	$16 - $177	40%
Blue Cross Blue Shield	$16 - $206	40%
UnitedHealthcare	$16 - $197	40%
Cigna	$22 - $128	54%
Mvp	$22 - $128	54%
Martin's Point Health Care	$26 - $48	64%
Ambetter / Centene	$26 - $43	64%
Martin's Point Generations Advantage	$26 - $43	64%
Wellcare Health Plans	$26 - $43	64%
Maine Community Health Options	$26 - $117	64%
Tufts Health Plan	$37 - $165	92%
First Health/Hcvm	$49 - $220	121%
PHCS	$52 - $233	129%
Mass General Brigham Health Plan	$58 - $259	144%

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 $44.
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 Cheshire Medical Center 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.