CMS Price Transparency Data

Diagnostic procedure preparation

Facility: Boston Medical Center

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0279
Insurance Median: $18
Cash Discount Price: $37
vs. Medicare Baseline: 0.45x Medicare

The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Boston Medical Center is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 0.45x the Medicare baseline. Located in 1 Boston Medical Center Place, Boston, MA.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$18

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$40.41

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $40.41 (100%)

Cash / Self-Pay: $37 (92%)

Insurance Median: $18 (45%)

Cash: $37 (92% of Medicare)

Ins. Median: $18 (45% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $40.41 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
Aetna	$15 - $40	37%
Blue Cross Blue Shield	$15 - $45	37%
Zzzunited [1008]	$15	37%
Fallon Sco [1126]	$15	37%
Medicare (plans)	$15 - $16	37%
UnitedHealthcare	$15	37%
Wellcare [1240]	$15	37%
Zzzcovid19 Hrsa Uninsured Testing and Treatment Fund [500010]	$15	37%
Ubh Hphc [8016]	$15	37%
Veterans Admin [9003]	$15	37%
Tufts [8002]	$15 - $82	37%
Corrections [9001]	$15 - $19	37%
Neighborhood Pace [1206]	$15	37%
Oxford Health [2024]	$15	37%
Senior Whole Health [1210]	$15	37%
Tufts Conncare/Qhp [8020]	$15 - $431	37%
United [2025]	$15	37%
Oxford Health [1007]	$15	37%
Humana	$15	37%
Eternalhealth [1227]	$16	40%
Cca [1215]	$16	40%
Zzzcca Onecare [1216]	$16	40%
Fallon [8008]	$20	49%
Champva [9004]	$23	57%
Tricare	$23	57%
Medicaid / KanCare	$30	74%
Uphams Corner Esp [1213]	$33	82%
Workers Comp [5002]	$35	87%
Zzzcity of Boston Work Comp [5003]	$35	87%
Zzzbu Employee Work Comp [5004]	$35	87%
Meritain Health [1023]	$40	99%
Mass General Brigham Health Plan Commercial [8009]	$44	109%
Wellpoint [2034]	$62	153%
Unicare [8004]	$62	153%
Cigna	$70 - $82	173%
Hsn Partial [4002]	$513	1269%
Hsn Dental [4006]	$513	1269%
Hsn [4001]	$513	1269%
Hsn Confidential [4007]	$513	1269%
Hsn Bad Debt [4003]	$513	1269%

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 $37.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0279.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Boston Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0279.
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.