CMS Price Transparency Data

Injection procedure for pain management

Facility: Texas Health Presbyterian Hospital Flower Mound

Billing Code: G0260 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0260
Insurance Median: $1,901
Cash Discount Price: $2,256
vs. Medicare Baseline: 2.64x Medicare

The contracted insurance negotiated median rate for a Injection procedure for pain management at Texas Health Presbyterian Hospital Flower Mound is $1,901. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,256. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 2.64x the Medicare baseline. Located in 4400 Long Prairie Road, Flower Mound, TX.

Cash / Self-Pay

$2,256

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,901

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$721.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $721.17 (100%)

Cash / Self-Pay: $2,256 (313%)

Insurance Median: $1,901 (264%)

Cash: $2,256 (313% of Medicare)

Ins. Median: $1,901 (264% of 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 264% of the Medicare baseline (a markup of 164%). 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
Amerigroup	$566 - $745	78%
Blue Cross Blue Shield	$566 - $5,223	78%
Cook Childrens	$566	78%
UnitedHealthcare	$566 - $3,076	78%
Superior Wellcare	$594 - $780	82%
Molina	$611 - $745	85%
Aetna	$623 - $2,635	86%
American Health	$709	98%
Healthspring	$723	100%
Humana	$737	102%
City of Fort Worth	$1,767	245%
Fort Worth Firefighters	$1,901 - $2,295	264%
Cigna	$2,078 - $3,537	288%
Quick Trip	$2,256 - $2,368	313%
PHCS	$2,613 - $2,801	362%
Healthsmart	$2,819 - $3,158	391%
Multiplan	$3,271	454%
Galaxy	$3,308	459%
USA	$3,308	459%

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 $2,256.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0260.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Texas Health Presbyterian Hospital Flower Mound is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0260.
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.