CMS Price Transparency Data

Colorectal cancer screening (alternative)

Facility: Ira Davenport Memorial Hospital

Billing Code: G0145 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0145
Insurance Median: $120
Cash Discount Price: $198
vs. Medicare Baseline: 4.53x Medicare

The contracted insurance negotiated median rate for a Colorectal cancer screening (alternative) at Ira Davenport Memorial Hospital is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $198. Compared to the federal Medicare reimbursement reference rate of $26.49, this hospital’s rate is 4.53x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$198

Average discount available for prompt cash payment at this facility.

Insurance Median

$120

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$26.49

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $26.49 (100%)

Cash / Self-Pay: $198 (747%)

Insurance Median: $120 (453%)

Cash: $198 (747% of Medicare)

Ins. Median: $120 (453% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $26.49 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 453% of the Medicare baseline (a markup of 353%). 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
Empire	$12	45%
Tricare	$26	98%
Blue Cross Blue Shield	$26 - $602	98%
Humana	$26 - $179	98%
Amerihealth Caritas McR Adv - All Plans	$27	102%
Fidelis	$28	106%
Fidelis Care - Exchange - All Plans	$109	411%
Geisinger - All Plans	$115	434%
Cigna	$124	468%
Mvp Health Plan - All Plans	$124	468%
Independent Health - All Plans	$129	487%
UPMC - All Plans	$137	517%
Pomco Inc - All Plans	$143	540%
UnitedHealthcare	$149	562%
Aetna	$149	562%
Emblem Health - All Plans	$175	661%
Martins Point - All Plans	$198	747%
Healthnow - All Plans	$653	2465%

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 $198.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0145.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ira Davenport Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0145.
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.