CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Saint Mary's Hospital

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0103
  • Insurance Median: $35
  • Cash Discount Price: $83
  • vs. Medicare Baseline: 1.81x Medicare
The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Saint Mary's Hospital is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 1.81x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$83

Average discount available for prompt cash payment at this facility.

Insurance Median
$35

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: $83 (430%)
Insurance Median: $35 (181%)
Cash: $83 (430% of Medicare)
Ins. Median: $35 (181% 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
Blue Cross Blue Shield $17 - $22 88%
Connecticut Dept of Correction $18 93%
Aetna $19 - $35 98%
Geha $19 98%
Cigna $19 - $120 98%
Medicare (plans) $19 - $20 98%
Cca Senior Care Options $19 98%
UnitedHealthcare $19 - $150 98%
Harvard Pilgrim Healthcare $19 98%
Connecticare $21 - $22 109%
Blue Distinction Transplant $22 114%
Blue Shield - PA (Highmark) $22 114%
Wellpoint $22 114%
Blue Shield - Ny Highmark Western $22 114%
Blue Care Network $22 114%
Unicare $22 114%
Kaiser Domestic $22 114%
Wc Domestic $22 114%
Blue Shield - Id (Regence) $22 114%
Blue Shield - Ny Highmark Northeastern $22 114%
Health Choices $22 114%
Pre-Employment $22 114%
Bcn Domestic $22 114%
Blue Shield - Ca $22 114%
Blue Benefit Administrators of Massachusetts $22 114%
Blue Shield - Wa (Regence) $22 114%
Centivo $24 124%
1199 National Benefit Fund $35 181%
Nippon Life Ins $35 181%
Gravie Admin Services $35 181%
Hap $35 181%
Webtpa $35 181%
Meritain $35 181%
Allied Benefit Systems $35 181%
Luminare Health $35 181%
Magnacare $37 192%
Health Partners $37 192%
Allegiance $37 192%
Innovative Health Plan II $41 212%
Claimdoc $41 212%
Diversified Administrators $41 212%
Carelon Behavioral Health $75 388%
Health New England $80 414%
Allied National Global Care $116 601%
Family Life Insurance Company $116 601%
Paramount HMO $116 601%
Multiplan $116 601%
Medi Share $116 601%
Trinity Health Share $116 601%
PHCS $116 601%
Pan-American Life $116 601%
Manhattan Life $116 601%
International Benefit Administrators $116 601%
Ghc Scw $116 601%
Mvp $116 601%
Asrm - Reliance Standard Life Insurance $116 601%
Pai $116 601%
Lifetime Benefit Solutions $116 601%
Dean Health $116 601%
Fallon Health $116 601%
Christian Care Ministry $116 601%
Prime Health Services $120 621%
Health Smart $128 663%
United Behavioral Health Eap $150 777%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals