CMS Price Transparency Data

Diagnostic procedure preparation

Facility: Sheridan Memorial Hospital

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0279
Insurance Median: $94
Cash Discount Price: $91
vs. Medicare Baseline: 2.33x Medicare

The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Sheridan Memorial Hospital is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.33x the Medicare baseline. Located in 1401 W 5Th St, Sheridan, WY.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$94

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$40.41

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $40.41 (100%)

Cash / Self-Pay: $91 (225%)

Insurance Median: $94 (233%)

Cash: $91 (225% of Medicare)

Ins. Median: $94 (233% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $40.41 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 233% of the Medicare baseline (a markup of 133%). 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
Humana	$27 - $40	67%
Blue Cross Blue Shield	$83 - $175	205%
Wy School Boards-All Plans	$84	208%
UnitedHealthcare	$86	213%
Pacificsource-All Plans	$88 - $112	218%
C1 Employee - All Plans	$90	223%
Casper Opco LLC - All Plans	$90	223%
First Health Comm - All Plans	$90	223%
Miscellaneous-All Plans	$90 - $114	223%
Cigna	$92 - $118	228%
Wise Provider Network-All Plans	$93 - $112	230%
Ebms - All Plans	$95	235%
First Choice Comm - All Plans	$95 - $121	235%
PHCS Multiplan-All Plans	$95 - $121	235%
Three Rivers-All Plans	$95 - $121	235%
Medi-Share Profee Only - All Plans	$114	282%

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 $91.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0279.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sheridan Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0279.
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.