CMS Price Transparency Data

Diagnostic procedure preparation

Facility: Robert Wood Johnson University Hospital - Somerset

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0279
  • Insurance Median: $101
  • Cash Discount Price: $68
  • vs. Medicare Baseline: 2.50x Medicare
The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Robert Wood Johnson University Hospital - Somerset is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.50x the Medicare baseline. Located in 110 Rehill Ave, Somerville, NJ.
Cash / Self-Pay
$68

Average discount available for prompt cash payment at this facility.

Insurance Median
$101

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: $68 (168%)
Insurance Median: $101 (250%)
Cash: $68 (168% of Medicare)
Ins. Median: $101 (250% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 250% of the Medicare baseline (a markup of 150%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $14 35%
Wellpoint $26 64%
UnitedHealthcare $33 - $77 82%
Fidelis Care $40 - $79 99%
Aetna $42 - $84 104%
Blue Cross Blue Shield $50 - $488 124%
Cigna $101 250%
First Health $160 - $320 396%
Qualcare Inc $203 - $406 502%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 110 Rehill Ave, Somerville, NJ 08876
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals