CMS Price Transparency Data

Diagnostic procedure preparation

Facility: CHI St Lukes Lakeside Hospital

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0279
Insurance Median: $87
Cash Discount Price: $55
vs. Medicare Baseline: 2.15x Medicare

The contracted insurance negotiated median rate for a Diagnostic procedure preparation at CHI St Lukes Lakeside Hospital is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.15x the Medicare baseline. Located in 17400 St Lukes Way, The Woodlands, TX.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$87

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: $55 (136%)

Insurance Median: $87 (215%)

Cash: $55 (136% of Medicare)

Ins. Median: $87 (215% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 215% of the Medicare baseline (a markup of 115%). 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
Tchp	$13 - $17	32%
Blue Cross Blue Shield	$36 - $85	89%
UnitedHealthcare	$43 - $165	106%
Wellpoint	$47 - $71	116%
United	$54 - $243	134%
Tchpchip	$55 - $70	136%
Chc	$61 - $87	151%
Cigna	$74 - $111	183%
Texastruechoice	$87	215%
Coventry	$103	255%
First Health	$103	255%
Humana	$103	255%
Healthsmart	$111	275%
Interlink	$111	275%
Multiplan	$118	292%
USA Health Network	$134	332%
Mhealth Network	$158	391%

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 $55.
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 CHI St Lukes Lakeside Hospital 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.