CMS Price Transparency Data

Injection procedure for pain management

Facility: St Luke's Warren Hospital

Billing Code: G0260 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0260
Insurance Median: $1,310
Cash Discount Price: $4,306
vs. Medicare Baseline: 1.82x Medicare

The contracted insurance negotiated median rate for a Injection procedure for pain management at St Luke's Warren Hospital is $1,310. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,306. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 1.82x the Medicare baseline. Located in 185 Roseberry St, Phillipsburg, NJ.

Cash / Self-Pay

$4,306

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,310

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: $4,306 (597%)

Insurance Median: $1,310 (182%)

Cash: $4,306 (597% of Medicare)

Ins. Median: $1,310 (182% 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.

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
Blue Cross Blue Shield	$763 - $4,843	106%
UnitedHealthcare	$763 - $1,292	106%
Aetna	$778 - $1,670	108%
Geisinger	$778 - $1,345	108%
Humana	$793	110%
UPMC Health Plan	$801 - $1,311	111%
Cigna	$885	123%
Oscar	$1,244	172%

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 $4,306.
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 St Luke's Warren Hospital 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.