CMS Price Transparency Data

Injection procedure for pain management

Facility: Montefiore Mount Vernon Hospital

Billing Code: G0260 (HCPCS)

The BaseRate · fair price high confidence

A fair price for this

$873

about 1.2× the $721 Medicare rate · typically $701–$1,763

modeled estimate · not a bill or quote

What this hospital charges insurers

$881

About the fair price

about $8 over the fair price · 1.2× Medicare

Medicare pays $721 Fair price $873 This hospital $881

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $664 Priciest $881

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

A fair price for a Injection procedure for pain management is about $873 (about 1.2× the $721 Medicare rate). Montefiore Mount Vernon Hospital charges insurers about $881 — about the fair price. Located in Mount Vernon, NY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$611 - $4,202	85%
Blue Cross Blue Shieldmajor	$611 - $6,702	85%
Aetnamajor	$3,621 - $4,051	502%
Humanamajor	$969	134%
Fidelis Care	$611 - $1,069	85%
Molina	$611 - $1,374	85%
MVP Health Care	$611 - $1,252	85%
Oscar Health	$3,549 - $7,276	492%
SelectHealth	$702	97%
WellCare	$617 - $899	86%
+ 14 smaller / regional plans	$507 - $18,107

Government programs also on file: Medicaid.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the HCPCS code on your bill matches exactly: G0260.

Insurance Before you use insurance

Call your insurance company to confirm Montefiore Mount Vernon Hospital is in-network.
Ask your insurer whether prior approval is required for HCPCS code G0260.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

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Other Procedures at Montefiore Mount Vernon Hospital

Compare: Injection procedure for pain management at other NY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.