CMS Price Transparency Data

Injection procedure for pain management

Facility: Thedacare Regional Medical Center - Appleton Inc

Billing Code: G0260 (HCPCS)

The BaseRate · fair price medium confidence

A fair price for this

$841

about 1.2× the $721 Medicare rate · typically $398–$1,939

modeled estimate · not a bill or quote

What this hospital charges insurers

$773

About the fair price

about $68 under the fair price · 1.1× Medicare

Medicare pays $721 Fair price $841 This hospital $773 Cash price $1,130 Hospital's list price $2,018

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 $773

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 $841 (about 1.2× the $721 Medicare rate). Thedacare Regional Medical Center - Appleton Inc charges insurers about $773, or about $1,130 in cash — about the fair price. Located in Appleton, WI.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Cigna✓ Humana AetnaKaiser 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	$193 - $1,771	27%
Blue Cross Blue Shieldmajor	$655 - $2,308	91%
Cignamajor	$1,464	203%
Humanamajor	$658	91%
HealthPartners	$1,576	219%
+ 1 smaller / regional plan	$1,233

Government programs also on file: Medicare, Medicaid.

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 1,130), 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 Thedacare Regional Medical Center - Appleton Inc 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 Thedacare Regional Medical Center - Appleton Inc

Compare: Injection procedure for pain management at other WI hospitals

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