CMS Price Transparency Data

Colorectal cancer screening

Facility: Southern Ocean Medical Center

Billing Code: G0010 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0010
Insurance Median: $67
Cash Discount Price: $50
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Colorectal cancer screening at Southern Ocean Medical Center is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 1.40x the Medicare baseline. Located in 1140 Rt 72 W, Manahawkin, NJ.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$47.84

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $47.84 (100%)

Cash / Self-Pay: $50 (105%)

Insurance Median: $67 (140%)

Cash: $50 (105% of Medicare)

Ins. Median: $67 (140% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $47.84 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
Aetna	$16 - $79	33%
Clover	$16	33%
Seoul Medical Group	$18	38%
Blue Cross Blue Shield	$50	105%
Karna	$50	105%
Vaccn	$50	105%
Wellcare	$50	105%
UnitedHealthcare	$52 - $68	109%
United Community/Americhoice	$53	111%
Horizon	$56 - $80	117%
Oxford	$63	132%
Bergen Risk	$66	138%
Cigna	$70 - $84	146%
Multiplan - PHCS	$75	157%
Amerihealth	$76 - $87	159%
Brighton Health Plan	$79	165%
Qualcare	$80	167%

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 $50.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0010.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Southern Ocean Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0010.
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.