Reported by 4 hospitals in the network under the fee schedule methodology.
Low
$114
Average
$232
Median
$200
High
$412
Filter by billing methodology
Reflects negotiated fee schedule rates with commercial payers.
| # | Hospital | Location | Approximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price. | |||||
|---|---|---|---|---|---|---|---|---|
| 1 | The Mount Sinai Hospital | New York, NY | $231 | $231 | — | — | $231 | $231 |
| 2 | Roswell Park Cancer Institute | Buffalo, NY | $117 | $170 | $87 | — | $99 | $293 |
| 3 | Kaleida Health | Buffalo, NY | $120 | $114 | $9 | — | $102 | $120 |
| 4 | South Shore Hospital | South Weymouth, MA | $412 | $412 | — | — | $412 | $412 |
Ask Claude or any MCP client for HCPCS G0004 pricing at a specific hospital — see how to connect.