CMS Price Transparency Data
Prostate cancer screening (blood test)
Facility: Clovis Community Medical Center
Billing Code: G0103 (HCPCS)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: G0103
- Insurance Median: $19
- Cash Discount Price: $170
- vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Clovis Community Medical Center is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 0.98x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
$170
Average discount available for prompt cash payment at this facility.
Insurance Median
$19
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: $170 (880%)
Insurance Median: $19 (98%)
Cash: $170 (880% of Medicare)
Ins. Median: $19 (98% 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.
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 |
|---|---|---|
| Sequoia Pace - Peak Tpa | $19 | 98% |
| Sante-Blue Shield/Sante | $19 | 98% |
| Advantek Table Mountain Rancheria Tribal Member | $19 | 98% |
| Blue Shield Promise - Imperial | $19 | 98% |
| Blue Shield 65 Plus HMO First Choice | $19 | 98% |
| Sante-Healthnet Seniority | $19 | 98% |
| Humana | $19 - $164 | 98% |
| Scan Health Plan | $19 | 98% |
| Bscphp - First Choice | $19 | 98% |
| Healthnet Sante Dual Risk | $19 | 98% |
| Sante Sub Cap-Blue Shield/Sante | $19 | 98% |
| Meritage Healthnet HMO | $19 | 98% |
| Care1St HMO - Ehs | $19 | 98% |
| Railroad Part A | $19 | 98% |
| Blue Shield | $19 - $110 | 98% |
| Blue Cross Blue Shield | $19 - $123 | 98% |
| Us Marshal | $19 | 98% |
| Healthnet HMO - Sante | $19 | 98% |
| Generic | $19 | 98% |
| Todays Pyramid | $19 | 98% |
| UnitedHealthcare | $19 - $101 | 98% |
| Victims of Crime | $19 | 98% |
| Aetna | $19 - $96 | 98% |
| Healthnet HMO - Dhmso | $19 | 98% |
| Bscphp - Dhmso | $19 | 98% |
| Generic Bscphp | $19 | 98% |
| Kaiser | $19 | 98% |
| Blue Shield 65 Plus HMO Ehs | $19 | 98% |
| Healthnet HMO - La Salle | $19 | 98% |
| Meritage Brand New Day | $19 | 98% |
| Bscphp HMO - First Choice | $19 | 98% |
| Hartford Life Supplement | $19 | 98% |
| Brand New Day | $19 | 98% |
| Blue Shield Sante | $19 | 98% |
| Gemcare HMO | $19 | 98% |
| Cigna | $19 - $120 | 98% |
| Sante | $19 | 98% |
| Meritage Blue Shield 65 Plus | $19 | 98% |
| Healthnet Sante - Sub Cap Dual Risk | $19 | 98% |
| Railroad Part B | $19 | 98% |
| Generic Victims of Crime | $19 | 98% |
| Healthnet HMO - Cvmp/Medpro | $19 | 98% |
| Wellcare | $19 | 98% |
| Healthnet Sante | $19 | 98% |
| Medicare (plans) | $19 | 98% |
| Blue Shield Hmo-Cvmp/Medpro | $19 | 98% |
| Railroad Part A & B | $19 | 98% |
| Sante-Sub Cap Ma Brand New Day | $19 | 98% |
| Cares Act Provider Relief Fund | $19 | 98% |
| Blue Shield Saint Agnes | $19 | 98% |
| Sante Sub Cap Healthnet Seniority | $19 | 98% |
| Medi-Cal Innovative Integrated Health | $19 | 98% |
| Alignment Health Plan | $21 | 109% |
| Champion Health Plan of California Ma | $21 | 109% |
| Innovative Integrated Health Community Plans HMO | $21 | 109% |
| Imperial Health Plan HMO | $22 | 114% |
| Correctcare Integrated Health | $25 | 129% |
| Coalinga State Hospital | $39 | 202% |
| Naphcare Inc-Mendota | $42 | 218% |
| Central Valley Medical Providers | $48 - $135 | 249% |
| Community Care | $49 - $59 | 254% |
| Employer 90/40 | $77 | 399% |
| Nx Health Network PPO | $106 | 549% |
| Central Ca Indian Health | $106 - $128 | 549% |
| Healthnet | $113 | 585% |
| Healthsmart | $131 - $154 | 678% |
| Network By Design | $145 | 751% |
| Coventry Health Care (First Health Network) | $145 | 751% |
| Generic Multiplan | $164 | 849% |
| PHCS | $164 | 849% |
| Well Path (Cfmg) | $212 - $256 | 1098% |