Injection procedure for pain management
Facility: Physicians Care Surgical Hospital
Billing Code: G0260 (HCPCS)
- CPT Billing Code: G0260
- Insurance Median: $1,641
- Cash Discount Price: $5,367
- vs. Medicare Baseline: 2.28x 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 $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 228% of the Medicare baseline (a markup of 128%). 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 |
|---|---|---|
| Tricare | $391 - $12,772 | 54% |
| Humana | $391 - $12,772 | 54% |
| Vibra Health Plan | $644 - $12,772 | 89% |
| Aarp | $644 - $12,772 | 89% |
| Ibc Security 65 | $644 - $12,363 | 89% |
| Keystone 65 HMO | $644 - $12,772 | 89% |
| Gpm Health and Life Insurance Mc Supplement | $644 - $12,772 | 89% |
| Medicare (plans) | $644 - $12,772 | 89% |
| Unified Health Services | $644 - $12,772 | 89% |
| Personal Choice 65 | $644 - $12,363 | 89% |
| Cigna | $644 - $18,977 | 89% |
| Pcsh Aarp | $644 - $12,772 | 89% |
| UnitedHealthcare | $644 - $27,099 | 89% |
| Aetna | $644 - $23,230 | 89% |
| Shenandoah Life | $644 - $12,772 | 89% |
| Blue Cross Blue Shield | $644 - $23,941 | 89% |
| Devon Health Services | $644 - $12,772 | 89% |
| Connecticare | $659 - $19,575 | 91% |
| Personal Choice | $696 - $18,753 | 97% |
| Keystone Direct POS | $696 - $18,753 | 97% |
| Amerihealth New Jersey HMO | $696 - $18,753 | 97% |
| Independence Bc | $696 - $18,753 | 97% |
| Empire Plan | $696 - $18,753 | 97% |
| Keystone HMO | $696 - $18,753 | 97% |
| Ibc 2021 | $696 - $18,753 | 97% |
| Independence Federal | $696 - $18,753 | 97% |
| Pcsh Ibc | $696 - $18,753 | 97% |
| Ibc | $696 - $18,753 | 97% |
| Horizon of New Jersey | $696 - $18,753 | 97% |
| Ibc - Local | $696 - $18,753 | 97% |
| Independence Administrators | $696 - $18,753 | 97% |
| Ibc Local | $696 - $18,753 | 97% |
| Amerihealth Administrators | $696 - $18,753 | 97% |
| Carefirst Administrators | $696 - $18,753 | 97% |
| Keystone Healthplan East | $696 - $18,753 | 97% |
| Regence Blue Shield | $696 - $18,753 | 97% |
| Keystone First Vip Choice | $900 - $2,850 | 125% |
| Keystone First | $900 - $2,850 | 125% |
| Straight Access | $900 - $2,850 | 125% |
| PA Health and Wellness | $900 - $2,850 | 125% |
| Keystone First Healthplan | $900 - $2,850 | 125% |
| Medicaid / KanCare | $900 - $2,850 | 125% |
| Highmark | $1,220 - $23,941 | 169% |
| UPMC | $1,273 - $19,295 | 177% |
| Healthgram | $1,364 - $18,977 | 189% |
| Nalc Health | $1,364 - $18,977 | 189% |
| Health Partners | $1,364 - $18,977 | 189% |
| Apwu | $1,364 - $18,977 | 189% |
| Cwi Benefits | $1,364 - $18,977 | 189% |
| Freedom Life Insurance Company | $1,364 - $18,977 | 189% |
| Loomis | $1,364 - $18,977 | 189% |
| Sana Benefits | $1,364 - $18,977 | 189% |
| Allsavers | $1,367 - $27,099 | 190% |
| Golden Rule Op | $1,367 - $27,099 | 190% |
| Oxford Life Insurance Company | $1,367 - $27,099 | 190% |
| Oxford Health Plan | $1,367 - $27,099 | 190% |
| Surest | $1,367 - $27,099 | 190% |
| Central PA Teamsters | $1,593 - $21,231 | 221% |
| Healthez | $1,641 - $23,230 | 228% |
| Allied Benefit Systems | $1,641 - $23,230 | 228% |
| Trustmark | $1,641 - $23,230 | 228% |
| Continental Benefits | $1,641 - $23,230 | 228% |
| Coventry | $1,641 - $23,230 | 228% |
| Premier Care Network | $1,641 - $23,230 | 228% |
| Ag Administrators | $1,641 - $23,230 | 228% |
| Marpai Health | $1,641 - $23,230 | 228% |
| Geha | $1,641 - $23,230 | 228% |
| Lucent Health | $1,641 - $23,230 | 228% |
| Meritain Health | $1,641 - $23,230 | 228% |
| Ag Administrators Inc | $1,641 - $23,230 | 228% |
| Allied Benefits Systems | $1,641 - $23,230 | 228% |