CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Othello Community Hospital

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0103
  • Insurance Median: $173
  • Cash Discount Price: $162
  • vs. Medicare Baseline: 8.96x Medicare
The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Othello Community Hospital is $173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $162. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 8.96x the Medicare baseline. Located in 315 North 14Th Avenue, Othello, WA.
Cash / Self-Pay
$162

Average discount available for prompt cash payment at this facility.

Insurance Median
$173

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: $162 (839%)
Insurance Median: $173 (896%)
Cash: $162 (839% of Medicare)
Ins. Median: $173 (896% 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 896% of the Medicare baseline (a markup of 796%). 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
Gau - All Plans $92 476%
Kaiser - All Plans $92 476%
Molina McAid $92 476%
Cocare - All Plans $92 476%
Chp McAid $92 476%
UnitedHealthcare $92 - $216 476%
Amerigroup McAid $92 476%
Ambetter / Centene $92 - $93 476%
Molina - All Other Plans $93 482%
Chp - All Other Plans $93 482%
Medicare (plans) $108 559%
Triwest - All Plans $140 725%
Tricare $140 725%
Travelers - All Plans $173 896%
Tpsc - All Plans $173 896%
Hmso - All Plans $173 896%
Hma - All Plans $173 896%
Asuris - All Plans $173 896%
Commercial Other - All Plans $173 896%
Veterans Admin - All Plans $173 896%
Blue Cross Blue Shield $181 937%
Cigna $192 994%
First Choice - All Plans $194 1005%
Aetna $203 1051%
Health Alliance McR Adv - All Plans $216 1119%
Wellcare McR Adv - All Plans $216 1119%
Chp McR Adv $216 1119%
Humana $216 1119%
Molina McAre $216 1119%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 315 North 14Th Avenue, Othello, WA 99344
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals