CMS Price Transparency Data

Injection procedure for pain management

Facility: Portneuf Medical Center

Billing Code: G0260 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0260
Insurance Median: $1,395
Cash Discount Price: $1,701
vs. Medicare Baseline: 1.93x Medicare

The contracted insurance negotiated median rate for a Injection procedure for pain management at Portneuf Medical Center is $1,395. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,701. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 1.93x the Medicare baseline. Located in 777 Hospital Way, Pocatello, ID.

Cash / Self-Pay

$1,701

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,395

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$721.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $721.17 (100%)

Cash / Self-Pay: $1,701 (236%)

Insurance Median: $1,395 (193%)

Cash: $1,701 (236% of Medicare)

Ins. Median: $1,395 (193% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $721.17 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.

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
Lucent Health [6000]	$930 - $1,395	129%
Oncology Patient Assistance Programs [2295]	$930 - $1,395	129%
Web Tpa [2115]	$930 - $1,395	129%
Healthcare Highways [2210]	$930 - $1,395	129%
Moda Health [6100]	$930 - $1,395	129%
Black Lung [6055]	$930 - $1,395	129%
Employee Benefit Management Services [2445]	$930 - $2,041	129%
Pending Ssi [1616]	$930 - $1,395	129%
Medishare Christian Care [1645]	$1,361 - $2,041	189%
Multiplan [1680]	$1,520 - $2,279	211%
UnitedHealthcare	$2,041 - $3,062	283%
Geha [1415]	$2,041 - $3,062	283%

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 $1,701.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0260.

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 G0260.
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.