CMS Price Transparency Data

Drug screening test

Facility: Upper Connecticut Valley Hospital

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0480
Insurance Median: $626
Cash Discount Price: $421
vs. Medicare Baseline: 5.47x Medicare

The contracted insurance negotiated median rate for a Drug screening test at Upper Connecticut Valley Hospital is $626. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $421. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 5.47x the Medicare baseline. Located in 181 Corliss Lane, Colebrook, NH.

Cash / Self-Pay

$421

Average discount available for prompt cash payment at this facility.

Insurance Median

$626

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: $421 (368%)

Insurance Median: $626 (547%)

Cash: $421 (368% of Medicare)

Ins. Median: $626 (547% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 547% of the Medicare baseline (a markup of 447%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$405	354%
Cigna	$597	522%
Blue Cross Blue Shield	$626 - $737	547%
Harvard Pilgrim Health Care - Commercial-Hmo	$737	644%

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 $421.
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 Upper Connecticut Valley 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.