CMS Price Transparency Data

Injection procedure for pain management

Facility: Good Samaritan Hospital of Suffern

Billing Code: G0260 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0260
Insurance Median: $3,471
Cash Discount Price: Unavailable
vs. Medicare Baseline: 4.81x Medicare

The contracted insurance negotiated median rate for a Injection procedure for pain management at Good Samaritan Hospital of Suffern is $3,471. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 4.81x the Medicare baseline. Located in 255 Lafayette Avenue, Suffern, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,471

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%)

Insurance Median: $3,471 (481%)

Ins. Median: $3,471 (481% 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 481% of the Medicare baseline (a markup of 381%). 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
World Trade Center Other	$877	122%
Medicare (plans)	$877 - $938	122%
Mvp Gold (McR)	$877	122%
Hamaspik (McR)	$877	122%
World Trade Center Fdny	$877	122%
Affinity By Molina McR	$921	128%
Beacon Exchange	$1,052	146%
Beacon Commercial	$1,140	158%
Geisinger Health Commercial/Exchange	$2,894	401%
Oxford Commercial	$3,431	476%
Oxford Exchange	$3,471	481%
UnitedHealthcare	$3,471 - $4,083	481%
Aetna	$3,947 - $4,386	547%
Blue Cross Blue Shield	$3,966 - $4,886	550%
Cigna	$4,340	602%
Self-Pay	$5,500	763%
Tricare	$6,185	858%
Magnacare Preferred	$8,760	1215%
Mvp Exchange	$12,212	1693%
Mvp Hmo/Ppo	$14,367	1992%

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 $X.
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 Good Samaritan Hospital of Suffern 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.