CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Cape Fear Valley Hoke Hospital

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0103
Insurance Median: $20
Cash Discount Price: $31
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Cape Fear Valley Hoke Hospital is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 1.04x the Medicare baseline. Located in 210 Medical Pavilion Drive, Raeford, NC.

Cash / Self-Pay

$31

Average discount available for prompt cash payment at this facility.

Insurance Median

$20

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: $31 (161%)

Insurance Median: $20 (104%)

Cash: $31 (161% of Medicare)

Ins. Median: $20 (104% 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.

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
Medicare (plans)	$19	98%
UnitedHealthcare	$19 - $68	98%
Wellcare	$19	98%
Longevity	$19	98%
First Carolina Care	$20	104%
Troy	$20 - $91	104%
New Hanover	$20	104%
Aetna	$20 - $48	104%
Liberty Advantage	$20	104%
Humana	$21	109%
Ambetter / Centene	$39	202%

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 $31.
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 Cape Fear Valley Hoke 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.