Diagnostic procedure preparation
Facility: Ohio Valley Surgical Hospital
Billing Code: G0279 (HCPCS)
- CPT Billing Code: G0279
- Insurance Median: $11,885
- Cash Discount Price: $64
- vs. Medicare Baseline: 294.11x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $40.41 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 29411% of the Medicare baseline (a markup of 29311%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medica | $39 - $17,571 | 97% |
| Surest | $39 - $17,571 | 97% |
| Shl | $39 - $17,571 | 97% |
| UnitedHealthcare | $39 - $17,571 | 97% |
| Ushealth | $39 - $17,571 | 97% |
| Oxford | $39 - $17,571 | 97% |
| Geha | $39 - $20,896 | 97% |
| Golden Rule | $39 - $17,571 | 97% |
| Mmoh | $48 - $11,885 | 119% |
| Mmoh (Supermed) | $49 | 121% |
| Mmo Cin. HMO | $49 - $67 | 121% |
| Personify Health | $54 - $20,896 | 134% |
| Nippon Life | $54 - $20,896 | 134% |
| Meritain | $54 - $20,896 | 134% |
| Mhbp | $54 - $20,896 | 134% |
| Ngs Coresource | $54 - $20,896 | 134% |
| Meritain Heatlh | $54 - $20,896 | 134% |
| Genworth | $54 - $20,896 | 134% |
| Pacific Source | $54 - $20,896 | 134% |
| Aetna | $54 - $20,896 | 134% |
| Mail Handlers | $54 - $20,896 | 134% |
| Medicare (plans) | $64 - $12,264 | 158% |
| Preferred Health | $95 | 235% |
| Ohio Health | $95 | 235% |
| Medben | $95 | 235% |
| Luminare Health | $95 | 235% |
| Blue Cross Blue Shield | $104 - $40,293 | 257% |
| Medicaid / KanCare | $3,557 - $17,827 | 8802% |
| Amerihealth Caritas of Ohio | $3,657 | 9050% |
| Buckeye Community Health Plan | $4,022 | 9953% |
| Molina McD | $4,084 | 10106% |
| Caresource | $4,364 - $17,827 | 10799% |
| Humana | $4,493 - $11,919 | 11119% |
| Medigold | $11,885 | 29411% |
| Prosperity Supplement | $11,885 | 29411% |
| American Continental Insurance | $11,885 | 29411% |
| Bankers Life and Casualty | $11,885 | 29411% |
| Molina Dual McR | $11,885 | 29411% |
| Self Pay Imaging | $11,885 | 29411% |
| American Republic | $11,885 | 29411% |
| Central States | $11,885 | 29411% |
| Patient No Pay | $11,885 | 29411% |
| Molina McR | $11,885 | 29411% |
| Molina McR McD | $11,885 | 29411% |
| Champus | $11,885 | 29411% |
| Wellcare By Allwell | $11,885 | 29411% |
| Molina McR+McD | $11,885 | 29411% |
| Communicare Advantage | $11,885 | 29411% |
| Gateway Health Plan | $11,885 | 29411% |
| American Continental Life | $11,885 | 29411% |
| Molina Dual McR | $11,885 | 29411% |
| Molina | $11,885 | 29411% |
| Bankers Fidelity | $11,885 | 29411% |
| Cigna | $11,885 - $18,817 | 29411% |
| Aultcare Primetime Health Plan | $11,885 | 29411% |
| Molina Marketplace | $11,885 | 29411% |
| Aarp | $11,885 | 29411% |
| American Retirement | $11,885 | 29411% |
| Wraparound Pl Supp | $11,885 | 29411% |
| Aarp Supplemental | $11,885 | 29411% |
| Everest | $11,885 | 29411% |
| The Health Plan | $12,479 | 30881% |
| Devoted Health | $13,707 | 33920% |
| Employer Direct | $15,703 | 38859% |
| Caresourse | $17,827 | 44115% |
| Samba | $18,817 | 46565% |
| Nalc | $18,817 | 46565% |
| Healthgram | $18,817 | 46565% |
| Unified Group | $18,817 | 46565% |
| Sbma | $18,817 | 46565% |