CMS Price Transparency Data

Injection procedure for pain management

Facility: Southern Ocean Medical Center

Billing Code: G0260 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0260
Insurance Median: $2,177
Cash Discount Price: $757
vs. Medicare Baseline: 3.02x Medicare

The contracted insurance negotiated median rate for a Injection procedure for pain management at Southern Ocean Medical Center is $2,177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $757. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 3.02x the Medicare baseline. Located in 1140 Rt 72 W, Manahawkin, NJ.

Cash / Self-Pay

$757

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,177

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: $757 (105%)

Insurance Median: $2,177 (302%)

Cash: $757 (105% of Medicare)

Ins. Median: $2,177 (302% 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 302% of the Medicare baseline (a markup of 202%). 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
Karna	$406	56%
Clover	$495	69%
Aetna	$509 - $9,383	71%
Seoul Medical Group	$564	78%
Blue Cross Blue Shield	$757	105%
Vaccn	$757	105%
Wellcare	$757	105%
United Community/Americhoice	$795	110%
Horizon	$903 - $2,514	125%
UnitedHealthcare	$908 - $4,986	126%
Bergen Risk	$2,062	286%
Cigna	$2,200 - $2,518	305%
Multiplan - PHCS	$2,338	324%
Amerihealth	$2,388 - $2,705	331%
Qualcare	$2,497	346%
Oxford	$4,125	572%
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 $757.
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 Southern 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.