CMS Price Transparency Data

Drug screening test

Facility: Harmon Memorial Hospital

Billing Code: G0480 (HCPCS)

The BaseRate · fair price medium confidence
A fair price for this
$119
about 1.0× the $114 Medicare rate · typically $55–$271
modeled estimate · not a bill or quote
Medicare pays $114 Fair price $119 Cash price $94 Hospital's list price $94

How we calculate the fair BaseRate →

What each insurance company pays

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

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

✓ Blue Cross Blue Shield✓ Aetna✓ Humana UnitedHealthcareCignaKaiser 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
Blue Cross Blue Shieldmajor $138 121%
Aetnamajor $35 - $112 31%
Humanamajor $35 - $99 31%
+ 1 smaller / regional plan $35 - $119
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 400 East Chestnut Street, Hollis, OK 73550
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals