CMS Price Transparency Data

Colorectal cancer screening

Facility: Portneuf Medical Center

Billing Code: G0010 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0010
Insurance Median: $139
Cash Discount Price: $94
vs. Medicare Baseline: 2.91x Medicare

The contracted insurance negotiated median rate for a Colorectal cancer screening at Portneuf Medical Center is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 2.91x the Medicare baseline. Located in 777 Hospital Way, Pocatello, ID.

Cash / Self-Pay

$94

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $94 (196%)

Insurance Median: $139 (291%)

Cash: $94 (196% of Medicare)

Ins. Median: $139 (291% 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 291% of the Medicare baseline (a markup of 191%). 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
UnitedHealthcare	$32 - $141	67%
Healthscope Benefits [2290]	$32	67%
Aetna	$32 - $133	67%
Pacific Source Health Plans [2850]	$47	98%
Lucent Health [6000]	$64	134%
Web Tpa [2115]	$64	134%
Moda Health [6100]	$64	134%
Employee Benefit Management Services [2445]	$64 - $94	134%
Pending Ssi [1616]	$64	134%
Healthcare Highways [2210]	$64 - $149	134%
Oncology Patient Assistance Programs [2295]	$64	134%
Black Lung [6055]	$64	134%
Medishare Christian Care [1645]	$94	196%
Liberty Health Share Lhs/Medcost Solutions LLC [2400]	$94	196%
Multiplan [1680]	$105 - $149	219%
First Health [1375]	$130	272%
Mailhandlers [1595]	$133	278%
Selecthealth [3740]	$133 - $141	278%
Cigna	$139	291%
Geha [1415]	$141	295%
Humana	$141	295%
Trustmark [2030]	$149	311%
Mutual of Omaha [1685]	$149	311%
Mayo Clinic Health Solutions [2280]	$149	311%
Administrative Concepts [1005]	$149	311%
UT Id Teamsters [3760]	$149	311%
Pba [1775]	$149	311%
Pan American Life Insurance Co [1770]	$149	311%
Hometown Health [2155]	$149	311%
Healthnet [1495]	$149	311%
New Era Life Insurance Company [1705]	$149	311%
Meritain Health [1655]	$149	311%
Healthfirst [2395]	$149	311%
Planned Administrators Inc [2360]	$149	311%
PHCS [1780]	$149	311%
National Association of Letter Carriers [1695]	$149	311%

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 $94.
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 Portneuf Medical Center 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.