CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Hillcrest Hospital Henryetta

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0103
Insurance Median: $198
Cash Discount Price: $74
vs. Medicare Baseline: 10.25x Medicare

The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Hillcrest Hospital Henryetta is $198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 10.25x the Medicare baseline. Located in 2401 W Main, Henryetta, OK.

Cash / Self-Pay

$74

Average discount available for prompt cash payment at this facility.

Insurance Median

$198

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: $74 (383%)

Insurance Median: $198 (1025%)

Cash: $74 (383% of Medicare)

Ins. Median: $198 (1025% 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 1025% of the Medicare baseline (a markup of 925%). 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
Black Lung [6055]	$62	321%
Lucent Health [6000]	$62	321%
Pba [1775]	$135	699%
Cigna	$135	699%
National Association of Letter Carriers [1695]	$135	699%
Healthpartners [1500]	$135	699%
Global Health [1430]	$153	792%
Multiplan [1680]	$167 - $212	865%
First Health [1375]	$167 - $212	865%
Healthcare Solutions [1485]	$175	906%
Group Resources [1455]	$198	1025%
Fmh Benefit Services [1390]	$198	1025%
PHCS [1780]	$198 - $212	1025%
Community Care [1290]	$198	1025%
Healthsmart [1505]	$210	1088%
New Era Life Insurance Company [1705]	$212	1098%
Trustmark [2030]	$212	1098%
Gilsbar [1425]	$212	1098%
Healthnet [1495]	$212	1098%
Allied National Global Care [1035]	$212	1098%
Administrative Concepts [1005]	$212	1098%
Pan American Life Insurance Co [1770]	$212	1098%
Allied Benefit Systems Inc [1030]	$212	1098%
Pending Ssi [1616]	$247	1279%

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 $74.
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 Hillcrest Hospital Henryetta 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.