CMS Price Transparency Data

Injection procedure for pain management

Facility: St Joseph's Hospital

Billing Code: G0260 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0260
  • Insurance Median: $1,528
  • Cash Discount Price: $1,619
  • vs. Medicare Baseline: 2.12x Medicare
The contracted insurance negotiated median rate for a Injection procedure for pain management at St Joseph's Hospital is $1,528. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,619. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 2.12x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$1,619

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,528

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: $1,619 (224%)
Insurance Median: $1,528 (212%)
Cash: $1,619 (224% of Medicare)
Ins. Median: $1,528 (212% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 212% of the Medicare baseline (a markup of 112%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Caterpillar, Inc. $159 - $1,315 22%
UnitedHealthcare $159 - $2,699 22%
Blue Cross Blue Shield $360 - $540 50%
Sae Hospice $360 - $540 50%
Clear Spring Health of Illinois $360 - $540 50%
Aetna $360 - $1,887 50%
Humana $360 - $540 50%
Molina Healthcare $360 - $926 50%
Amish Community $503 - $756 70%
Naphcare $755 - $1,134 105%
Celtic Insurance Company $791 - $1,188 110%
Hopetrust $899 - $1,350 125%
Claim Doc $899 - $1,350 125%
Meridian Health Plan $970 135%
Wellfirst $1,151 - $1,728 160%
Cigna $1,205 - $1,808 167%
First Health $1,329 - $1,995 184%
Healthlink $1,528 - $2,294 212%
Multiplan/Phcs $1,528 - $2,294 212%
Provider Network of America $1,618 - $2,429 224%
Healthcare Finest Network (Hfn) $1,618 - $2,429 224%
Health Alliance Medical Plans $1,798 - $2,699 249%
Consociate Group $1,798 - $2,699 249%
Interplan $1,798 - $2,699 249%
Current Health Solutions $1,798 - $2,699 249%
Healthscope $1,798 - $2,699 249%
Qtc Medical Group of Illinois $1,798 - $2,699 249%
Illinois Breast and Cervical Cancer Program $1,798 - $2,699 249%
Mental Health Network $1,798 - $2,699 249%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals