CMS Price Transparency Data

Colorectal cancer screening

Facility: Mercy Hospital of Buffalo

Billing Code: G0010 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0010
Insurance Median: $24
Cash Discount Price: $93
vs. Medicare Baseline: 0.50x Medicare

The contracted insurance negotiated median rate for a Colorectal cancer screening at Mercy Hospital of Buffalo is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $93. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 0.50x the Medicare baseline. Located in 565 Abbott Road, Buffalo, NY.

Cash / Self-Pay

$93

Average discount available for prompt cash payment at this facility.

Insurance Median

$24

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: $93 (194%)

Insurance Median: $24 (50%)

Cash: $93 (194% of Medicare)

Ins. Median: $24 (50% 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
Blue Cross Blue Shield	$5 - $20	10%
Medicaid / KanCare	$11 - $35	23%
Independent Health Essential [100166]	$11 - $42	23%
UnitedHealthcare	$15 - $31	31%
Univera Healthcare Essential [100170]	$17	36%
Univera Healthcare [100169]	$17 - $22	36%
UPMC Health Plan [100181]	$17	36%
Medicare (plans)	$19 - $51	40%
Humana	$24	50%
VA Veterans Affairs [700001]	$28	59%
Covid19 Hrsa [45013]	$31	65%
Cigna	$31	65%
Fallon Health [450115]	$31	65%
Seneca Nation [450119]	$31	65%
Hospice [550001]	$31	65%
Fidelis Dual Advantage [450120]	$33	69%
Wellcare Fidelis Dual [450451]	$33	69%
Wellcare [450129]	$35	73%
Iha First Choice [800001]	$40 - $66	84%
Independent Health [100165]	$40 - $85	84%

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 $93.
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 Mercy Hospital of Buffalo 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.