CMS Price Transparency Data
Diagnostic procedure preparation
Facility: Clovis Community Medical Center
Billing Code: G0279 (HCPCS)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: G0279
- Insurance Median: $42
- Cash Discount Price: $197
- vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Clovis Community Medical Center is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $197. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.04x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
$197
Average discount available for prompt cash payment at this facility.
Insurance Median
$42
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: $197 (488%)
Insurance Median: $42 (104%)
Cash: $197 (488% of Medicare)
Ins. Median: $42 (104% 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 |
|---|---|---|
| Healthnet HMO - Dhmso | $14 - $42 | 35% |
| Blue Cross Blue Shield | $14 - $156 | 35% |
| Sante Sub Cap Healthnet Seniority | $14 - $42 | 35% |
| Generic Victims of Crime | $14 - $42 | 35% |
| Bscphp HMO - First Choice | $14 - $42 | 35% |
| Humana | $14 - $209 | 35% |
| Blue Shield | $14 - $4,696 | 35% |
| UnitedHealthcare | $14 - $129 | 35% |
| Medi-Cal Innovative Integrated Health | $14 - $42 | 35% |
| Sequoia Pace - Peak Tpa | $14 - $42 | 35% |
| Scan Health Plan | $14 - $42 | 35% |
| Sante-Sub Cap Ma Brand New Day | $14 - $42 | 35% |
| Blue Shield 65 Plus HMO First Choice | $14 - $42 | 35% |
| Aetna | $14 - $123 | 35% |
| Sante Sub Cap-Blue Shield/Sante | $14 - $42 | 35% |
| Meritage Brand New Day | $14 - $42 | 35% |
| Healthnet HMO - La Salle | $14 - $42 | 35% |
| Care1St HMO - Ehs | $14 - $42 | 35% |
| Meritage Blue Shield 65 Plus | $14 - $42 | 35% |
| Blue Shield Promise - Imperial | $14 - $42 | 35% |
| Blue Shield Hmo-Cvmp/Medpro | $14 - $42 | 35% |
| Gemcare HMO | $14 - $42 | 35% |
| Railroad Part A & B | $14 - $42 | 35% |
| Generic Bscphp | $14 - $42 | 35% |
| Railroad Part B | $14 - $42 | 35% |
| Cigna | $14 - $153 | 35% |
| Meritage Healthnet HMO | $14 - $42 | 35% |
| Generic | $14 - $42 | 35% |
| Healthnet Sante | $14 - $42 | 35% |
| Victims of Crime | $14 - $42 | 35% |
| Blue Shield Sante | $14 - $42 | 35% |
| Medicare (plans) | $14 - $42 | 35% |
| Bscphp - Dhmso | $14 - $42 | 35% |
| Sante-Healthnet Seniority | $14 - $42 | 35% |
| Blue Shield 65 Plus HMO Ehs | $14 - $42 | 35% |
| Cares Act Provider Relief Fund | $14 - $42 | 35% |
| Healthnet Sante - Sub Cap Dual Risk | $14 - $42 | 35% |
| Bscphp - First Choice | $14 - $42 | 35% |
| Sante | $14 - $74 | 35% |
| Well Path (Cfmg) | $14 - $271 | 35% |
| Brand New Day | $14 - $42 | 35% |
| Hartford Life Supplement | $14 - $42 | 35% |
| Healthnet Sante Dual Risk | $14 - $42 | 35% |
| Advantek Table Mountain Rancheria Tribal Member | $14 - $42 | 35% |
| Wellcare | $14 - $42 | 35% |
| Blue Shield Saint Agnes | $14 - $42 | 35% |
| Sante-Blue Shield/Sante | $14 - $42 | 35% |
| Todays Pyramid | $14 - $42 | 35% |
| Railroad Part A | $14 - $42 | 35% |
| Healthnet HMO - Sante | $14 - $42 | 35% |
| Healthnet HMO - Cvmp/Medpro | $14 - $42 | 35% |
| Us Marshal | $14 - $42 | 35% |
| Innovative Integrated Health Community Plans HMO | $15 - $46 | 37% |
| Champion Health Plan of California Ma | $15 - $46 | 37% |
| Alignment Health Plan | $15 - $46 | 37% |
| Imperial Health Plan HMO | $16 - $49 | 40% |
| Correctcare Integrated Health | $18 - $55 | 45% |
| Coalinga State Hospital | $28 - $84 | 69% |
| Naphcare Inc-Mendota | $30 - $91 | 74% |
| Kaiser | $42 | 104% |
| Fresno County Funded Specialty Care | $48 | 119% |
| Medi-Cal Contra Costa Health Plan | $48 | 119% |
| Santa Clara Family Health Plan - Valley Health | $48 | 119% |
| Ccs Mariposa | $48 | 119% |
| Medi-Cal Partnership Health Plan of Ca | $48 | 119% |
| Generic Care Out of County | $48 | 119% |
| Medi-Cal California Health & Wellness Plan | $48 | 119% |
| Ccs Kings | $48 | 119% |
| Generic Ccs Other Counties | $48 | 119% |
| Ccs Stanislaus | $48 | 119% |
| Medi-Cal Community Health Group | $48 | 119% |
| Medi-Cal Cencal Health | $48 | 119% |
| Medi-Cal Kern Family Health | $48 | 119% |
| Medi-Cal Health Plan of San Mateo | $48 | 119% |
| Chdp | $48 | 119% |
| Medi-Cal La Care Health | $48 | 119% |
| Cal Caloptima | $48 | 119% |
| Medi-Cal Blue Shield Promise Health | $48 | 119% |
| Ccs Tulare | $48 | 119% |
| San Francisco Health Plan Medi-Cal | $48 | 119% |
| Ccs Merced | $48 | 119% |
| Medi-Cal Inland Empire Health | $48 | 119% |
| Medi-Cal Alameda Alliance for Health | $48 | 119% |
| Medi-Cal Molina | $48 | 119% |
| Genetically Handicapped Person | $48 | 119% |
| Ccs Kern | $48 | 119% |
| Ccs Madera/Sacramento | $48 | 119% |
| Santa Clara Family Health Plan - Premier Health | $48 | 119% |
| Gold Coast Medi-Cal | $48 | 119% |
| Ccs Fresno | $48 | 119% |
| Central Valley Medical Providers | $62 - $172 | 153% |
| Community Care | $63 | 156% |
| Health Plan of San Joaquin | $71 | 176% |
| Sequoia Pace | $71 | 176% |
| Adventist -McL Calviva Sub Cap | $78 | 193% |
| Healthnet | $92 - $144 | 228% |
| Employer 90/40 | $98 | 243% |
| Central Ca Indian Health | $135 | 334% |
| Nx Health Network PPO | $135 | 334% |
| Healthsmart | $167 - $197 | 413% |
| Coventry Health Care (First Health Network) | $184 | 455% |
| Network By Design | $184 | 455% |
| PHCS | $209 | 517% |
| Generic Multiplan | $209 | 517% |