CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Kapiolani Medical Center for Women & Children

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0103
Insurance Median: $39
Cash Discount Price: $67
vs. Medicare Baseline: 2.02x Medicare

The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Kapiolani Medical Center for Women & Children is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $67. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 2.02x the Medicare baseline. Located in 1319 Punahou Street, Honolulu, HI.

Cash / Self-Pay

$67

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $67 (347%)

Insurance Median: $39 (202%)

Cash: $67 (347% of Medicare)

Ins. Median: $39 (202% 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 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.

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
Hmsa	$19 - $39	98%
Kaiser	$19 - $98	98%
Alohacare	$19 - $21	98%
Mdx	$19 - $21	98%
Devoted	$20	104%
Ohana	$23 - $32	119%
Hcha	$37	192%
UnitedHealthcare	$38	197%
Pac Admin	$41	212%
Uha	$42 - $56	218%
Hwmg/Hmaa	$47	243%
Mimoh	$78 - $83	404%
Calvos	$83	430%
Verdegard	$89	461%
Multiplan	$89 - $94	461%
McCp	$94	487%
Coventry	$100	518%

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 $67.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0103.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Kapiolani Medical Center for Women & Children is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0103.
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.