CMS Price Transparency Data

Injection procedure for pain management

Facility: Rush Memorial Hospital

Billing Code: G0260 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0260
Insurance Median: $2,158
Cash Discount Price: $2,415
vs. Medicare Baseline: 2.99x Medicare

The contracted insurance negotiated median rate for a Injection procedure for pain management at Rush Memorial Hospital is $2,158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,415. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 2.99x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$2,415

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,158

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: $2,415 (335%)

Insurance Median: $2,158 (299%)

Cash: $2,415 (335% of Medicare)

Ins. Median: $2,158 (299% 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 299% of the Medicare baseline (a markup of 199%). 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
Health Net	$948	131%
Caresource McR Adv	$998	138%
UnitedHealthcare	$998 - $2,576	138%
My True Advantage - All Plans	$998	138%
Aetna	$1,008 - $2,963	140%
Humana	$1,008 - $2,963	140%
Viant Beech St McR Adv	$1,028	143%
Blue Cross Blue Shield	$1,028 - $2,359	143%
Today's Option McR Adv-All Plans	$1,028	143%
Caresource Marketplace-All Other Plans	$1,597	221%
Cigna	$2,576	357%
Phcs-All Plans	$2,576	357%
Consumers Life Ins-All Plans	$2,898	402%
Coventry/First Health-All Plans	$2,898	402%
Siho-All Plans	$2,963	411%
Sagamore-All Plans	$2,963	411%
Multiplan-All Plans	$2,995	415%
Community Health Alliance-All Plans	$3,027	420%
Encore Health Services-All Plans	$3,156	438%

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 $2,415.
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 Rush Memorial Hospital 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.