CMS Price Transparency Data

Diagnostic procedure preparation

Facility: Grandview Medical Center

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0279
Insurance Median: $346
Cash Discount Price: $111
vs. Medicare Baseline: 8.56x Medicare

The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Grandview Medical Center is $346. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 8.56x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$346

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: $111 (275%)

Insurance Median: $346 (856%)

Cash: $111 (275% of Medicare)

Ins. Median: $346 (856% 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 856% of the Medicare baseline (a markup of 756%). 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
Al Bccedp	$11	27%
Veterans Eval Services	$13	32%
Node Champva	$13	32%
Tricare	$13	32%
Encompass Health	$18	45%
UnitedHealthcare	$51 - $9,150	126%
Self Pay	$69 - $3,050	171%
Node Us Dept of Labor	$71	176%
Blue Cross Blue Shield	$87	215%
Bp Health Advocate	$115 - $5,083	285%
Aetna	$128	317%
Viva Health	$138 - $3,861	341%
Choicecare	$161 - $3,500	398%
Ag Administrators	$161 - $7,117	398%
Alamed	$161 - $7,117	398%
Drummond	$161 - $7,117	398%
American Employee Alliance	$184 - $8,133	455%
Value Options	$230 - $10,167	569%
Healthchoice	$230 - $12,200	569%
First Health	$277 - $15,901	685%
Multiplan	$281 - $14,233	695%
Blue Bell Creameries	$323 - $14,233	799%
Natl Comp Care	$346 - $15,250	856%
USA PPO	$346 - $15,250	856%
Coventry Work Comp Al	$360 - $15,901	891%
Novanet	$372 - $16,419	921%
Alabama Wc	$392 - $17,283	970%
Corvel	$392 - $17,283	970%
Cal-Med	$392 - $17,283	970%
Associated Admin	$415 - $18,300	1027%

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 $111.
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 Grandview Medical Center 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.