CMS Price Transparency Data

Diagnostic procedure preparation

Facility: Southern Hills Hospital and Medical Center

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0279
Insurance Median: $28
Cash Discount Price: $1,267
vs. Medicare Baseline: 0.69x Medicare

The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Southern Hills Hospital and Medical Center is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,267. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 0.69x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.

Cash / Self-Pay

$1,267

Average discount available for prompt cash payment at this facility.

Insurance Median

$28

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: $1,267 (3135%)

Insurance Median: $28 (69%)

Cash: $1,267 (3135% of Medicare)

Ins. Median: $28 (69% 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 - $19	30%
Hometown Health McR	$13 - $19	32%
Ambetter / Centene	$13 - $276	32%
Alignment Health Plan	$13 - $19	32%
United	$13 - $287	32%
Blue Cross Blue Shield	$13 - $52	32%
Caremore	$13 - $20	32%
Select Health	$13 - $303	32%
Triwest	$13 - $19	32%
Imperial Nv	$14 - $21	35%
Universal Healthcare	$15 - $23	37%
Health Net	$15 - $19	37%
Sierra Hpn	$27 - $58	67%
Molina Healthcare	$27 - $60	67%
Community Care Health	$27 - $58	67%
Sierra	$41	101%
Cigna	$55 - $124	136%
Aetna	$270	668%
Prominence Healthfirst	$394	975%
Cmn Global	$552	1366%
Evernorth	$658	1628%
Hometown Health Providers	$658	1628%
Nv Health & Welfare Trust	$789	1952%
Multiplan	$828 - $960	2049%
First Health	$868 - $1,052	2148%
Medcare International	$986	2440%
Olympus Medsave USA	$986	2440%

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 $1,267.
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 Southern Hills 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.