CMS Price Transparency Data

Diagnostic procedure preparation

Facility: Sunrise Hospital and Medical Center

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0279
Insurance Median: $33
Cash Discount Price: $123
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Sunrise Hospital and Medical Center is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 0.82x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $123 (304%)

Insurance Median: $33 (82%)

Cash: $123 (304% of Medicare)

Ins. Median: $33 (82% 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
Humana	$12 - $54	30%
Caremore	$13 - $45	32%
Hometown Health McR	$13 - $19	32%
Alignment Health Plan	$13 - $43	32%
United	$13 - $62	32%
Ambetter / Centene	$13 - $62	32%
Triwest Healthcare Alliance	$13 - $19	32%
Select Health	$13 - $121	32%
Blue Cross Blue Shield	$13 - $62	32%
Imperial Nv	$14 - $21	35%
Health Net	$15 - $19	37%
Healthcare Partners of Nv	$15 - $61	37%
Universal Healthcare	$15 - $23	37%
Aetna	$15 - $72	37%
Hometown Health Providers	$17 - $82	42%
Silver Summit	$19 - $65	47%
Culinary Health Fund	$23 - $64	57%
Multiplan	$25 - $90	62%
Molina Healthcare	$27 - $60	67%
Sierra Hpn	$27 - $58	67%
Community Care Health	$27 - $58	67%
Sierra	$29 - $70	72%
Health Plan Nevada	$32 - $62	79%
Amerigroup	$32 - $59	79%
Molina	$33 - $65	82%
Prominence Healthfirst	$37	92%
Cmn Global	$52	129%
Cigna	$55 - $124	136%
Nv Health & Welfare Trust	$74	183%
First Health	$81 - $98	200%
Olympus Medsave USA	$92	228%
Medcare International	$92	228%

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 $123.
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 Sunrise Hospital and 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.