Prostate cancer screening (blood test)
Facility: Pioneer Medical Center
Billing Code: G0103 (HCPCS)
- CPT Billing Code: G0103
- Insurance Median: $202
- Cash Discount Price: $170
- vs. Medicare Baseline: 10.46x 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 1046% of the Medicare baseline (a markup of 946%). 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 |
|---|---|---|
| Healtnet Federal-All Plans | $96 | 497% |
| Health Info Net McR Adv | $96 | 497% |
| Blue Cross Blue Shield | $96 - $177 | 497% |
| Humana | $96 - $196 | 497% |
| UnitedHealthcare | $96 - $202 | 497% |
| Triwest VA Pccc-All Plans | $96 | 497% |
| Rocky Mountain Health Network-All Plans | $149 | 772% |
| Allegiance Provider-All Plans | $181 | 937% |
| Mountain Health Co-Op Hpn | $187 | 968% |
| City of Billings-All Plans | $202 | 1046% |
| First Choice Big Sky-All Plans | $202 | 1046% |
| Pacific Steel & Recycling-All Plans | $202 | 1046% |
| First Health-All Plans | $202 | 1046% |
| Americas Choice-All Plans | $202 | 1046% |
| 6 Degrees Health-All Plans | $202 | 1046% |
| Ebms Select Care Network-All Plans | $202 | 1046% |
| Interwest PPO | $202 | 1046% |
| Pacific Source-All Plans | $202 | 1046% |
| Three Rivers-All Plans | $202 | 1046% |
| Community Health Ntwk-All Plans | $202 | 1046% |
| Mountain Health Co-Op-All Other Plans | $202 | 1046% |
| Fedmed Network-All Plans | $202 | 1046% |
| Health Info Net Standard-All Other Plans | $207 | 1072% |
| Health Info Net Peak/Equity | $207 | 1072% |
| Mountain Health Co-Op Ppo/Pos | $209 | 1082% |
| Interwest Health Traditional-All Other Plans | $213 | 1103% |