CMS Price Transparency Data
Prostate cancer screening (blood test)
Facility: Watsonville Community Hospital
Billing Code: G0103 (HCPCS)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: G0103
- Insurance Median: $610
- Cash Discount Price: $610
- vs. Medicare Baseline: 31.59x Medicare
The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Watsonville Community Hospital is $610. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $610. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 31.59x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$610
Average discount available for prompt cash payment at this facility.
Insurance Median
$610
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$19.31
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $19.31 (100%)
Cash / Self-Pay: $610 (3159%)
Insurance Median: $610 (3159%)
Cash: $610 (3159% of Medicare)
Ins. Median: $610 (3159% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $19.31 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 3159% of the Medicare baseline (a markup of 3059%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Workers Comp | $19 | 98% |
| Health Net of California | $19 - $637 | 98% |
| Keenan & Assoc Work Comp | $19 | 98% |
| Western Growers Work Comp | $19 | 98% |
| Hartford Workers' Comp | $19 | 98% |
| Secure Horizons Dign HMO | $19 - $203 | 98% |
| Pinnacle Healthcare Uc | $19 | 98% |
| Kemper Group Workers Comp | $19 | 98% |
| Fleming & Associates | $19 | 98% |
| UnitedHealthcare | $19 - $610 | 98% |
| Fireman's Fund Work Comp | $19 | 98% |
| Miscellaneous Work Comp | $19 | 98% |
| Nx Health Network | $19 | 98% |
| Tricare | $19 | 98% |
| Beta Healthcare Group | $19 | 98% |
| Republic Idemnity W/Comp | $19 | 98% |
| Secure Horizons | $19 | 98% |
| Medicare (plans) | $19 | 98% |
| Liberty Mutual Work Comp | $19 | 98% |
| U.S. Dept. of Labor | $19 | 98% |
| Alignment Health Plan | $19 | 98% |
| Veterans Administration | $19 | 98% |
| Blue Shield PPO | $19 - $61 | 98% |
| Ace-Usa | $19 | 98% |
| Crawford & Co | $19 | 98% |
| Travelers Insurance | $19 - $1,016 | 98% |
| Gallagher Bassett Svcs | $19 | 98% |
| Ufcw/Valley Clerks | $61 | 316% |
| Healthy Families | $61 | 316% |
| United Agriculture | $61 | 316% |
| Bs Employee | $61 | 316% |
| Sheet Metal Workers | $123 - $905 | 637% |
| Robert Kennedy/Ccn | $123 - $905 | 637% |
| Western Growers Trust/Bc | $123 - $905 | 637% |
| Laborers Health & Welfare | $123 - $905 | 637% |
| Blue Cross Blue Shield | $123 - $905 | 637% |
| Operating Engineers | $123 - $905 | 637% |
| Monterey Bay Pub Emp Trst | $123 - $905 | 637% |
| Teamsters Benefit Trust | $123 - $905 | 637% |
| City of Wats/Pinnacle Clm | $123 - $905 | 637% |
| State Compensation Fund | $123 - $905 | 637% |
| Claims Management Wc | $123 - $905 | 637% |
| Pinnacle Claims Tpa/Bc | $123 - $905 | 637% |
| Calif Ironworkers Field | $123 - $905 | 637% |
| Carpenters H&W Trust | $123 - $905 | 637% |
| Delta Health Systems | $123 - $905 | 637% |
| Medicruz | $183 | 948% |
| Victim Compensation Plan | $183 - $1,016 | 948% |
| Aetna | $203 - $833 | 1051% |
| Pacificare HMO | $203 - $610 | 1051% |
| Great-West/Phcs | $203 - $711 | 1051% |
| Cigna | $203 - $711 | 1051% |
| Blue Shield HMO | $203 | 1051% |
| Health Net Pmg HMO | $203 - $637 | 1051% |
| Western Health Advantage | $508 | 2631% |
| Pacificare PPO | $610 | 3159% |
| Health Net Smartcare Netw | $610 | 3159% |
| Self Pay | $610 | 3159% |
| Health Net Canopycare HMO | $637 | 3299% |
| Health Net Blue and Gold | $637 | 3299% |
| Geha (Ccn) | $711 - $813 | 3682% |
| First Health | $711 - $813 | 3682% |
| Adventist Risk Management | $711 - $813 | 3682% |
| Transwestern | $711 - $813 | 3682% |
| Multiplan Inc PPO | $793 | 4107% |
| Private Healthcare System | $793 | 4107% |
| Salinas Valley Mem Hops | $864 | 4474% |
| Coastal Healthcare Admin | $864 - $915 | 4474% |
| Apwu Health Plan | $1,016 | 5262% |
| Aarp | $1,016 | 5262% |
| Farmers Insurance | $1,016 | 5262% |
| Miscellaneous Insurance | $1,016 | 5262% |
| Humana | $1,016 | 5262% |
| North Calif Bakery Driver | $1,016 | 5262% |
| Bankers Life & Casualty | $1,016 | 5262% |
| Physicians Mutual | $1,016 | 5262% |
| Wholesale Beer Distributo | $1,016 | 5262% |
| Sutter Health Plus | $1,016 | 5262% |
| United Administrative | $1,016 | 5262% |
| Miscellaneous Auto | $1,016 | 5262% |
| Well Path | $1,016 | 5262% |
| Aaa | $1,016 | 5262% |
| Prucare Pmg POS | $1,016 | 5262% |
| Zenith National Ins | $1,016 | 5262% |
| Prucare Pmg HMO | $1,016 | 5262% |
| Allstate | $1,016 | 5262% |
| State Farm Ins | $1,016 | 5262% |