CMS Price Transparency Data

Injection procedure for pain management

Facility: Uva Health Culpeper Medical Center

Billing Code: G0260 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0260
Insurance Median: $1,456
Cash Discount Price: $1,017
vs. Medicare Baseline: 2.02x Medicare

The contracted insurance negotiated median rate for a Injection procedure for pain management at Uva Health Culpeper Medical Center is $1,456. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,017. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 2.02x the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$1,017

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,456

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: $1,017 (141%)

Insurance Median: $1,456 (202%)

Cash: $1,017 (141% of Medicare)

Ins. Median: $1,456 (202% 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 202% of the Medicare baseline (a markup of 102%). 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
Aetna	$418 - $1,511	58%
Blue Ridge Pace [10510]	$637	88%
Medicaid / KanCare	$637	88%
Multiplan Generic [40035]	$670 - $2,710	93%
Vhn Generic [40040]	$670 - $2,710	93%
Blue Cross Blue Shield	$708 - $2,115	98%
Cigna	$708 - $4,433	98%
HMO Part B [10099]	$708	98%
Humana	$708 - $745	98%
Medicare (plans)	$708 - $730	98%
UnitedHealthcare	$708 - $4,834	98%
VA Ccn [99926]	$708 - $730	98%
VA Ccn [99927]	$708 - $730	98%
Veterans Administration [99910]	$730	101%
Kaiser Permenente [40014]	$793 - $2,869	110%
Geha [40009]	$1,066 - $3,317	148%
Sentara [40021]	$1,167 - $1,192	162%
Sentara Behavioral Health [40052]	$1,192	165%
Beacon Health Options [40012]	$1,594	221%
Commercial Contracted Hb Only [40056]	$1,674	232%
Commercial Generic [40000]	$1,674 - $2,232	232%
Commercial Contracted Tpa [40055]	$1,913 - $2,232	265%
Umwa [40037]	$2,232	309%
Carefirst [30007]	$2,296 - $2,600	318%
Healthsmart [40013]	$2,391	332%
First Health Generic [40033]	$2,614	362%
Champva [50002]	$2,693	373%
Tricare	$2,693	373%
Gateway Health Alliance [40034]	$2,710	376%
Onenet Workers Comp Generic [60010]	$2,793	387%

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 $1,017.
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 Uva Health Culpeper Medical Center 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.