Prostate cancer screening (blood test)
Facility: Johnson Memorial Hospital
Billing Code: G0103 (HCPCS)
- CPT Billing Code: G0103
- Insurance Median: $39
- Cash Discount Price: $86
- vs. Medicare Baseline: 2.02x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 202% of the Medicare baseline (a markup of 102%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Connecticut Dept of Correction | $18 | 93% |
| UnitedHealthcare | $19 - $157 | 98% |
| Aetna | $19 - $39 | 98% |
| Blue Cross Blue Shield | $19 - $39 | 98% |
| Medicare (plans) | $19 - $20 | 98% |
| Cigna | $19 - $122 | 98% |
| Harvard Pilgrim Healthcare | $19 | 98% |
| Geha | $19 | 98% |
| Cca Senior Care Options | $19 | 98% |
| Centivo | $24 | 124% |
| Fallon Health | $25 | 129% |
| Connecticare | $31 - $34 | 161% |
| Meritain | $39 | 202% |
| Blue Shield - Wa (Regence) | $39 | 202% |
| Health Choices | $39 | 202% |
| Wc Domestic | $39 | 202% |
| Blue Benefit Administrators of Massachusetts | $39 | 202% |
| Kaiser Domestic | $39 | 202% |
| Webtpa | $39 | 202% |
| Blue Shield - Ny Highmark Western | $39 | 202% |
| Pre-Employment | $39 | 202% |
| Luminare Health | $39 | 202% |
| Blue Shield - Ca | $39 | 202% |
| Blue Care Network | $39 | 202% |
| Unicare | $39 | 202% |
| Gravie Admin Services | $39 | 202% |
| Blue Shield - PA (Highmark) | $39 | 202% |
| Bcn Domestic | $39 | 202% |
| Blue Shield - Id (Regence) | $39 | 202% |
| Allied Benefit Systems | $39 | 202% |
| 1199 National Benefit Fund | $39 | 202% |
| Blue Distinction Transplant | $39 | 202% |
| Blue Shield - Ny Highmark Northeastern | $39 | 202% |
| Wellpoint | $39 | 202% |
| Nippon Life Ins | $39 | 202% |
| Hap | $39 | 202% |
| Diversified Administrators | $41 | 212% |
| Innovative Health Plan II | $41 | 212% |
| Claimdoc | $41 | 212% |
| Health New England | $102 | 528% |
| Magnacare | $111 | 575% |
| Allegiance | $111 | 575% |
| Health Partners | $111 | 575% |
| Prime Health Services | $126 | 653% |
| Asrm - Reliance Standard Life Insurance | $130 | 673% |
| Family Life Insurance Company | $130 | 673% |
| Lifetime Benefit Solutions | $130 | 673% |
| Medi Share | $130 | 673% |
| International Benefit Administrators | $130 | 673% |
| Trinity Health Share | $130 | 673% |
| Manhattan Life | $130 | 673% |
| Dean Health | $130 | 673% |
| Ghc Scw | $130 | 673% |
| Paramount HMO | $130 | 673% |
| Mvp | $130 | 673% |
| PHCS | $130 | 673% |
| Allied National Global Care | $130 | 673% |
| Pan-American Life | $130 | 673% |
| Christian Care Ministry | $130 | 673% |
| Multiplan | $130 | 673% |
| Pai | $130 | 673% |
| Health Smart | $133 | 689% |
| United Behavioral Health Eap | $157 | 813% |