CMS Price Transparency Data

Drug screening test

Facility: Boston Children's Hospital

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0480
Insurance Median: $105
Cash Discount Price: $146
vs. Medicare Baseline: 0.92x Medicare

The contracted insurance negotiated median rate for a Drug screening test at Boston Children's Hospital is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 0.92x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $146 (128%)

Insurance Median: $105 (92%)

Cash: $146 (128% of Medicare)

Ins. Median: $105 (92% 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
United Ri Nj Ny	$12 - $318	10%
UnitedHealthcare	$12 - $428	10%
Cigna	$12 - $455	10%
Mgb/Allways	$12 - $373	10%
Ambetter / Centene	$12 - $319	10%
Humana	$12 - $454	10%
Community Health Options	$12 - $454	10%
Multiplan/Phcs	$12 - $479	10%
Coventry/Hcvm/First Health	$12 - $464	10%
Harvard Pilgrim	$12 - $341	10%
Carelon Strategies/Bhs	$12 - $328	10%
Blue Cross Blue Shield	$12 - $333	10%
Tufts Public Plan	$12 - $310	10%
United	$13 - $421	11%
Aetna	$13 - $422	11%
Carelon/Beacon	$14 - $378	12%
Fallon	$14 - $389	12%
Health New England	$15 - $407	13%
Cdphp	$16 - $428	14%
Ets/Lifetrac	$16 - $428	14%
Interlink Transplant	$16 - $428	14%
Unicare	$339	296%

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 $146.
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 Boston Children's Hospital 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.