CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Mary Hitchcock Memorial Hospital

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0103
  • Insurance Median: $20
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Mary Hitchcock Memorial Hospital is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 1.04x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.
Cash / Self-Pay
Unavailable

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%)
Insurance Median: $20 (104%)
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.

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
UnitedHealthcare $8 - $77 41%
Cigna $10 - $20 52%
Blue Cross Blue Shield $13 - $122 67%
Harvard Pilgrim Health Care of Ne $13 - $98 67%
Granite State Health Plan $17 - $19 88%
Aetna $17 - $44 88%
Beacon Health Strategies/Carelon $17 - $18 88%
Amerihealth Caritas Nh $17 - $18 88%
Wellsense Health Plan $17 - $20 88%
Mvp $19 - $20 98%
Martin's Point Generations Advantage $19 98%
Martin's Point Health Care $20 104%
Ambetter / Centene $20 - $63 104%
Wellcare Health Plans $20 104%
Mass General Brigham Health Plan $47 243%
Tufts Health Plan $56 - $71 290%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Medical Center Drive, Lebanon, NH 03756
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals