CMS Price Transparency Data

Injection procedure for pain management

Facility: St Nicholas Hospital

Billing Code: G0260 (HCPCS)

The BaseRate · fair price high confidence

A fair price for this

$906

about 1.3× the $721 Medicare rate · typically $663–$1,765

modeled estimate · not a bill or quote

What this hospital charges insurers

$910

About the fair price

about $4 over the fair price · 1.3× Medicare

Medicare pays $721 Fair price $906 This hospital $910 Cash price $1,680 Hospital's list price $2,545

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $576 Priciest $910

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a Injection procedure for pain management is about $906 (about 1.3× the $721 Medicare rate). St Nicholas Hospital charges insurers about $910, or about $1,680 in cash — about the fair price. Located in Sheboygan, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$669 - $2,701	93%
Blue Cross Blue Shieldmajor	$197 - $2,701	27%
Aetnamajor	$669 - $2,701	93%
Cignamajor	$1,782 - $1,891	247%
Humanamajor	$669 - $2,701	93%
Health Net	$1,123 - $2,701	156%
Medica	$669 - $690	93%
Meridian	$197 - $203	27%
Molina	$208 - $1,351	29%
Security Health Plan	$676 - $1,724	94%
+ 15 smaller / regional plans	$197 - $2,701

Government programs also on file: Medicare, Medicaid.

Excludes 6 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,680), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the HCPCS code on your bill matches exactly: G0260.

Insurance Before you use insurance

Call your insurance company to confirm St Nicholas Hospital is in-network.
Ask your insurer whether prior approval is required for HCPCS code G0260.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Nicholas Hospital

Compare: Injection procedure for pain management at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.