CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Portneuf Medical Center

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0103
  • Insurance Median: $215
  • Cash Discount Price: $156
  • vs. Medicare Baseline: 11.13x Medicare
The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Portneuf Medical Center is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 11.13x the Medicare baseline. Located in 777 Hospital Way, Pocatello, ID.
Cash / Self-Pay
$156

Average discount available for prompt cash payment at this facility.

Insurance Median
$215

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: $156 (808%)
Insurance Median: $215 (1113%)
Cash: $156 (808% of Medicare)
Ins. Median: $215 (1113% 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 1113% of the Medicare baseline (a markup of 1013%). 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.

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
Bannock County Jail [6050] $44 228%
Pending County Rca [3910] $44 228%
Medicaid / KanCare $44 228%
UnitedHealthcare $44 - $234 228%
Department of Corrections [1340] $44 228%
Aetna $54 - $220 280%
Healthscope Benefits [2290] $54 280%
Moda Health [6100] $107 554%
Oncology Patient Assistance Programs [2295] $107 554%
Healthcare Highways [2210] $107 - $247 554%
Black Lung [6055] $107 554%
Employee Benefit Management Services [2445] $107 - $156 554%
Pending Ssi [1616] $107 554%
Web Tpa [2115] $107 554%
Lucent Health [6000] $107 554%
Pacific Source Health Plans [2850] $149 772%
Liberty Health Share Lhs/Medcost Solutions LLC [2400] $156 808%
Medishare Christian Care [1645] $156 808%
Multiplan [1680] $174 - $247 901%
Worker's Comp [2125] $189 - $195 979%
Cigna $191 989%
Transamerican Life [1990] $195 1010%
Enablecomp [1350] $195 1010%
First Health [1375] $214 1108%
Selecthealth [3740] $220 - $234 1139%
Mailhandlers [1595] $220 1139%
Humana $234 1212%
Geha [1415] $234 1212%
Mutual of Omaha [1685] $247 1279%
Trustmark [2030] $247 1279%
Meritain Health [1655] $247 1279%
National Association of Letter Carriers [1695] $247 1279%
Administrative Concepts [1005] $247 1279%
Pba [1775] $247 1279%
Healthfirst [2395] $247 1279%
Mayo Clinic Health Solutions [2280] $247 1279%
Pan American Life Insurance Co [1770] $247 1279%
PHCS [1780] $247 1279%
Healthnet [1495] $247 1279%
Hometown Health [2155] $247 1279%
New Era Life Insurance Company [1705] $247 1279%
UT Id Teamsters [3760] $247 1279%
Planned Administrators Inc [2360] $247 1279%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 777 Hospital Way, Pocatello, ID 83201
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals