CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Holy Cross Hospital-Davis

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0103
  • Insurance Median: $201
  • Cash Discount Price: $156
  • vs. Medicare Baseline: 10.41x Medicare
The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Holy Cross Hospital-Davis is $201. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 10.41x the Medicare baseline. Located in 1600 West Antelope Drive, Layton, UT.
Cash / Self-Pay
$156

Average discount available for prompt cash payment at this facility.

Insurance Median
$201

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: $156 (808%)
Insurance Median: $201 (1041%)
Cash: $156 (808% of Medicare)
Ins. Median: $201 (1041% 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 1041% of the Medicare baseline (a markup of 941%). 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.

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
Blue Cross Blue Shield $13 - $234 67%
Uuhp $16 - $212 83%
Cigna $16 - $312 83%
Medicaid / KanCare $16 83%
Humana $19 98%
Medicare (plans) $19 98%
Centura Employee Plan $23 119%
Employer Direct Healthcare $24 124%
Motivhealth $25 129%
Select Health $34 - $192 176%
Molina $39 - $168 202%
Pehp $167 - $227 865%
Aetna $173 - $330 896%
Wise $203 - $207 1051%
Deseret Mutual Benefit Administrators $240 1243%
Multiplan $269 - $355 1393%
UnitedHealthcare $283 - $391 1466%
Emi Health $340 1761%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 West Antelope Drive, Layton, UT 84041
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals