CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: St Francis Hospital

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0103
Insurance Median: $238
Cash Discount Price: $201
vs. Medicare Baseline: 12.33x Medicare

The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at St Francis Hospital is $238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $201. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 12.33x the Medicare baseline. Located in 1215 Franciscan Dr, Litchfield, IL.

Cash / Self-Pay

$201

Average discount available for prompt cash payment at this facility.

Insurance Median

$238

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: $201 (1041%)

Insurance Median: $238 (1233%)

Cash: $201 (1041% of Medicare)

Ins. Median: $238 (1233% 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 1233% of the Medicare baseline (a markup of 1133%). 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
Molina Healthcare	$12 - $279	62%
Wexford	$12	62%
Meridian Health Plan	$13	67%
Clear Spring Health of Illinois	$59 - $279	306%
Humana	$59 - $279	306%
Blue Cross Blue Shield	$59 - $279	306%
UnitedHealthcare	$61 - $279	316%
Aetna	$61 - $279	316%
Amish Community	$78	404%
Celtic Insurance Company	$141 - $614	730%
Claim Doc	$146 - $698	756%
Hopetrust	$160 - $698	829%
Wellfirst	$179	927%
First Health	$207	1072%
Cigna	$223	1155%
Caterpillar, Inc.	$224	1160%
Current Health Solutions	$234	1212%
Multiplan/Phcs	$237	1227%
Consociate Group	$237	1227%
Healthlink	$238	1233%
Provider Network of America	$251	1300%
Healthcare Finest Network (Hfn)	$251	1300%
Illinois Breast and Cervical Cancer Program	$279	1445%
Health Alliance Medical Plans	$279	1445%
Live360	$279	1445%
Interplan	$279	1445%
Naphcare	$279	1445%
Healthscope	$279	1445%

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 $201.
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 St Francis Hospital 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.