CMS Price Transparency Data

Colorectal cancer screening

Facility: Piedmont Walton Hospital

Billing Code: G0010 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0010
Insurance Median: $155
Cash Discount Price: $62
vs. Medicare Baseline: 3.24x Medicare

The contracted insurance negotiated median rate for a Colorectal cancer screening at Piedmont Walton Hospital is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 3.24x the Medicare baseline. Located in 2151 W Spring Street, Monroe, GA.

Cash / Self-Pay

$62

Average discount available for prompt cash payment at this facility.

Insurance Median

$155

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$47.84

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $47.84 (100%)

Cash / Self-Pay: $62 (130%)

Insurance Median: $155 (324%)

Cash: $62 (130% of Medicare)

Ins. Median: $155 (324% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $47.84 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 324% of the Medicare baseline (a markup of 224%). 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
Medicaid / KanCare	$19 - $20	40%
Alliant Health Plans of Georgia [10952]	$141	295%
First Health [10303]	$145	303%
Aetna	$147	307%
Novanet [10819]	$155	324%
Multiplan [10600]	$166	347%
PHCS [10601]	$166	347%
Kaiser [10500]	$176	368%
Beechstreet [10800]	$186	389%
UnitedHealthcare	$207	433%

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 $62.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0010.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Piedmont Walton Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0010.
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.