CMS Price Transparency Data

Diagnostic procedure preparation

Facility: Northeast Regional Medical Center

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0279
Insurance Median: $57
Cash Discount Price: $39
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Northeast Regional Medical Center is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.41x the Medicare baseline. Located in 315 S Osteopathy, Kirksville, MO.

Cash / Self-Pay

$39

Average discount available for prompt cash payment at this facility.

Insurance Median

$57

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: $39 (97%)

Insurance Median: $57 (141%)

Cash: $39 (97% of Medicare)

Ins. Median: $57 (141% 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
Node Champva	$13	32%
Veterans Eval Services	$13	32%
Tricare	$13	32%
Self Pay	$23 - $58	57%
Blue Cross Blue Shield	$30 - $32	74%
Cigna	$33 - $41	82%
Aetna	$36 - $88	89%
Medicaid / KanCare	$37 - $61	92%
UnitedHealthcare	$62 - $79	153%
Access Health Services, LLC	$63 - $68	156%
Multiplan	$73 - $84	181%
Healthlink	$73 - $84	181%
Coventry Wc	$78 - $84	193%

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 $39.
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 Northeast Regional 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.