CMS Price Transparency Data

Diagnostic procedure preparation

Facility: Ira Davenport Memorial Hospital

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0279
Insurance Median: $65
Cash Discount Price: $63
vs. Medicare Baseline: 1.61x Medicare

The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Ira Davenport Memorial Hospital is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.61x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$63

Average discount available for prompt cash payment at this facility.

Insurance Median

$65

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: $63 (156%)

Insurance Median: $65 (161%)

Cash: $63 (156% of Medicare)

Ins. Median: $65 (161% 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
Empire	$10 - $37	25%
Blue Cross Blue Shield	$41 - $314	101%
Tricare	$41	101%
Humana	$41 - $93	101%
Amerihealth Caritas McR Adv - All Plans	$42	104%
Fidelis	$54	134%
Fidelis Care - Exchange - All Plans	$57	141%
Geisinger - All Plans	$60	148%
Mvp Health Plan - All Plans	$65	161%
Cigna	$65	161%
Independent Health - All Plans	$67	166%
UPMC - All Plans	$72	178%
Pomco Inc - All Plans	$75	186%
Aetna	$78 - $92	193%
Emblem Health - All Plans	$91	225%
Emblem/Ghi	$96	238%
Martins Point - All Plans	$104	257%
UnitedHealthcare	$109 - $526	270%
Healthnow - All Plans	$341	844%

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 $63.
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 Ira Davenport Memorial Hospital 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.