CMS Price Transparency Data

Injection procedure for pain management

Facility: Ocean Medical Center

Billing Code: G0260 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0260
Insurance Median: $2,094
Cash Discount Price: $725
vs. Medicare Baseline: 2.90x Medicare

The contracted insurance negotiated median rate for a Injection procedure for pain management at Ocean Medical Center is $2,094. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $725. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 2.90x the Medicare baseline. Located in 425 Jack Martin Blvd, Brick, NJ.

Cash / Self-Pay

$725

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,094

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$721.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $721.17 (100%)

Cash / Self-Pay: $725 (101%)

Insurance Median: $2,094 (290%)

Cash: $725 (101% of Medicare)

Ins. Median: $2,094 (290% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $721.17 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 290% of the Medicare baseline (a markup of 190%). 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	$390 - $8,419	54%
Karna	$406 - $415	56%
Clover	$495	69%
Seoul Medical Group	$534 - $591	74%
Amerigroup	$693	96%
Horizon	$693 - $10,671	96%
Vaccn	$693 - $757	96%
Wellcare	$693 - $757	96%
United Community/Americhoice	$727 - $795	101%
Blue Cross Blue Shield	$757	105%
UnitedHealthcare	$908 - $5,092	126%
Activecare First McO	$1,925 - $2,338	267%
Intergroup	$1,925	267%
Bergen Risk	$2,062	286%
Qualcare	$2,137 - $6,256	296%
Prime Health	$2,200	305%
Cigna	$2,248 - $2,519	312%
Multiplan - PHCS	$2,338	324%
Amerihealth	$2,363 - $2,676	328%
Oxford	$4,090	567%
Brighton Health Plan	$9,933	1377%

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 $725.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0260.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ocean Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0260.
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.