CMS Price Transparency Data

Drug screening test

Facility: Holyoke Medical Center

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0480
Insurance Median: $118
Cash Discount Price: $308
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Drug screening test at Holyoke Medical Center is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $308. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 1.03x the Medicare baseline. Located in 575 Beech Street, Holyoke, MA.

Cash / Self-Pay

$308

Average discount available for prompt cash payment at this facility.

Insurance Median

$118

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$114.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $114.43 (100%)

Cash / Self-Pay: $308 (269%)

Insurance Median: $118 (103%)

Cash: $308 (269% of Medicare)

Ins. Median: $118 (103% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $114.43 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
Bmchp	$60	52%
Fallon	$60 - $123	52%
Health New England	$60 - $112	52%
Wellsense Direct Metals Silver	$75	66%
UnitedHealthcare	$80 - $174	70%
Tufts Health Plan	$112 - $132	98%
Aetna	$112 - $114	98%
Blue Cross Blue Shield	$112 - $228	98%
Commonwealth Care Alliance	$118	103%
Wellsense Sco	$119	104%
Wellcare	$120	105%
Senior Whole Health	$129	113%
Tufts Health Public Plans	$135	118%
Cigna	$166	145%
Gic Unicare	$173	151%
Harvard Pilgrim	$174	152%

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 $308.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0480.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Holyoke Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0480.
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.