CMS Price Transparency Data

Drug screening test

Facility: Saint Clare's Hospital/ Denville Campus

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0480
  • Insurance Median: $87
  • Cash Discount Price: $114
  • vs. Medicare Baseline: 0.76x Medicare
The contracted insurance negotiated median rate for a Drug screening test at Saint Clare's Hospital/ Denville Campus is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 0.76x the Medicare baseline. Located in 25 Pocono Road, Denville, NJ.
Cash / Self-Pay
$114

Average discount available for prompt cash payment at this facility.

Insurance Median
$87

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: $114 (100%)
Insurance Median: $87 (76%)
Cash: $114 (100% of Medicare)
Ins. Median: $87 (76% 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.

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 $17 - $243 15%
Ally-Align (Fka Spartan Health Plan) $17 - $120 15%
Amerihealth $17 - $114 15%
Brighton Health Plan Solutions (Fka Magnacare) $17 - $173 15%
Cigna $17 - $166 15%
Clover Health $17 - $114 15%
Coventry $17 - $229 15%
Employer Direct Healthcare $17 - $160 15%
Fairprice Healthcare Holdings - Fphh $17 - $137 15%
Horizon $17 - $423 15%
Humana $17 - $92 15%
Medicare (plans) $17 - $114 15%
Tricare $17 - $114 15%
UnitedHealthcare $17 - $114 15%
Wellcare $17 - $154 15%
Wellpoint Amerigroup $17 - $114 15%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 25 Pocono Road, Denville, NJ 07834
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals