CMS Price Transparency Data

Diagnostic procedure preparation

Facility: Ascension Seton Hays

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0279
Insurance Median: $53
Cash Discount Price: $54
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Ascension Seton Hays is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.31x the Medicare baseline. Located in 6001 Kyle Pkwy, Kyle, TX.

Cash / Self-Pay

$54

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$40.41

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $40.41 (100%)

Cash / Self-Pay: $54 (134%)

Insurance Median: $53 (131%)

Cash: $54 (134% of Medicare)

Ins. Median: $53 (131% of 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.

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	$25 - $102	62%
Champva	$26 - $54	64%
Humana	$44	109%
Dell Chip/Chip Perinate	$52 - $53	129%
Dell Star	$52 - $53	129%
UnitedHealthcare	$52 - $53	129%
Wellpoint Star	$52 - $53	129%
Wellpoint Star Plus	$52 - $53	129%
Ambetter / Centene	$53	131%
Wellpoint Chip/Chip Perinate	$53	131%
Wellpoint Star Kids	$53	131%
Community Health Services	$57	141%
Superior Star	$60	148%
Superior Star Foster	$60	148%
Superior Star Kids	$60	148%
Superior Star Plus	$60	148%
Superior Chip/Chip Perinate	$67	166%
Cigna	$83	205%

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 $54.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0279.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ascension Seton Hays is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0279.
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.