CMS Price Transparency Data

Diagnostic procedure preparation

Facility: Charleston Area Medical Center

Billing Code: G0279 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0279
Insurance Median: $108
Cash Discount Price: $228
vs. Medicare Baseline: 2.67x Medicare

The contracted insurance negotiated median rate for a Diagnostic procedure preparation at Charleston Area Medical Center is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $228. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 2.67x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$228

Average discount available for prompt cash payment at this facility.

Insurance Median

$108

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: $228 (564%)

Insurance Median: $108 (267%)

Cash: $228 (564% of Medicare)

Ins. Median: $108 (267% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 267% of the Medicare baseline (a markup of 167%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$17 - $244	42%
The Health Plan of West Virginia Inc.	$17 - $242	42%
Unicare Health Plan of West Virginia Inc.	$17 - $63	42%
Optimum Choice Inc.	$23 - $100	57%
Triwest VA	$27 - $60	67%
Choicecare Network	$28 - $244	69%
Blue Cross Blue Shield	$28 - $227	69%
UnitedHealthcare	$29 - $244	72%
West Virginia Senior Advantage Inc.	$29 - $65	72%
Integrated Medical Solutions	$54 - $121	134%
Naphcare	$56 - $124	139%
Tricare	$67 - $149	166%
Caresource	$69 - $156	171%
City of Charleston	$83 - $187	205%
Cigna	$103 - $232	255%
Three Rivers Providers Network	$108 - $242	267%
Multiplan	$109 - $244	270%
Healthsmart	$109 - $244	270%

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 $228.
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 Charleston Area 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.