CMS Price Transparency Data

Injection procedure for pain management

Facility: Univ. of Vermont - Fletcher Allen Health Care

Billing Code: G0260 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0260
Insurance Median: $573
Cash Discount Price: $686
vs. Medicare Baseline: 0.79x Medicare

The contracted insurance negotiated median rate for a Injection procedure for pain management at Univ. of Vermont - Fletcher Allen Health Care is $573. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $686. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 0.79x the Medicare baseline. Located in 111 Colchester Ave, Burlington, VT.

Cash / Self-Pay

$686

Average discount available for prompt cash payment at this facility.

Insurance Median

$573

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: $686 (95%)

Insurance Median: $573 (79%)

Cash: $686 (95% of Medicare)

Ins. Median: $573 (79% 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.

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
UnitedHealthcare	$240 - $698	33%
Veterans Affairs Community Care Network	$313 - $698	43%
Wellpath	$377 - $1,047	52%
Blue Cross Blue Shield	$480 - $712	67%
Ebpa	$528	73%
St. Regis	$549 - $698	76%
Magnacare	$549	76%
Harvard Pilgrim	$549	76%
Cigna	$573	79%
Mvp	$573 - $715	79%
Coventry	$583	81%
Nppn	$617	86%
Capital District Physicians' Health Plan	$698	97%
Aetna	$698	97%
Humana	$698	97%
Martins Point	$715 - $2,879	99%
Fidelis Care	$768	106%

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 $686.
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 Univ. of Vermont - Fletcher Allen Health Care 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.