CMS Price Transparency Data

Drug screening test

Facility: Spotsylvania Regional Medical Center

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0480
Insurance Median: $453
Cash Discount Price: $1,619
vs. Medicare Baseline: 3.96x Medicare

The contracted insurance negotiated median rate for a Drug screening test at Spotsylvania Regional Medical Center is $453. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,619. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 3.96x the Medicare baseline. Located in 4600 Spotsylvania Parkway, Fredericksburg, VA.

Cash / Self-Pay

$1,619

Average discount available for prompt cash payment at this facility.

Insurance Median

$453

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$114.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $114.43 (100%)

Cash / Self-Pay: $1,619 (1415%)

Insurance Median: $453 (396%)

Cash: $1,619 (1415% of Medicare)

Ins. Median: $453 (396% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $114.43 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 396% of the Medicare baseline (a markup of 296%). 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
Devoted	$114	100%
Humana	$114	100%
Johns Hopkins	$114	100%
Sentara Health	$114	100%
United	$114 - $729	100%
United Behavioral Health	$114	100%
Aetna	$116	101%
Virginia Premier Health	$117	102%
Blue Cross Blue Shield	$118 - $598	103%
Cigna	$119 - $568	104%
Evernorth Behavioral Health	$119	104%
Clear Spring Health Plan	$120	105%
Align Senior Care	$122	107%
Bright Health	$245	214%
Lifeworks	$308	269%
Virginia Health Network	$567 - $1,052	495%
Kaiser	$955	835%
Greenvbrier Sporting Club	$971	849%
Multiplan	$1,149	1004%
Corvel	$1,166	1019%
Occunet Workers Comp	$1,295	1132%
4Most Health Nework	$1,457	1273%
Three Rivers Provider Network	$1,457	1273%

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 $1,619.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0480.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Spotsylvania Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0480.
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.