CMS Price Transparency Data

Injection procedure for pain management

Facility: Sunrise Hospital and Medical Center

Billing Code: G0260 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0260
Insurance Median: $393
Cash Discount Price: $216
vs. Medicare Baseline: 0.54x Medicare

The contracted insurance negotiated median rate for a Injection procedure for pain management at Sunrise Hospital and Medical Center is $393. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 0.54x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.

Cash / Self-Pay

$216

Average discount available for prompt cash payment at this facility.

Insurance Median

$393

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$721.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $721.17 (100%)

Cash / Self-Pay: $216 (30%)

Insurance Median: $393 (54%)

Cash: $216 (30% of Medicare)

Ins. Median: $393 (54% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $721.17 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
Blue Cross Blue Shield	$107 - $3,720	15%
Aetna	$166 - $1,706	23%
Sierra	$213 - $1,865	30%
Sierra Hpn	$259	36%
Molina Healthcare	$259 - $269	36%
Community Care Health	$259	36%
Caresource	$269	37%
Select Health	$332 - $393	46%
United	$460 - $2,086	64%
Corvel	$1,135	157%
Olympus Medsave USA	$1,195	166%
Hometown Health Providers	$1,429 - $1,745	198%
Ambetter / Centene	$2,213	307%
Health Services Coalition	$4,260	591%

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 $216.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0260.

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 G0260.
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.