Prostate cancer screening (blood test)
Facility: Mount Sinai Rehabilitation Hospital Inc
Billing Code: G0103 (HCPCS)
- CPT Billing Code: G0103
- Insurance Median: $78
- Cash Discount Price: $86
- vs. Medicare Baseline: 4.04x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 404% of the Medicare baseline (a markup of 304%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Connecticut Dept of Correction | $18 | 93% |
| Harvard Pilgrim Healthcare | $19 | 98% |
| Blue Cross Blue Shield | $19 - $78 | 98% |
| Geha | $19 | 98% |
| Medicare (plans) | $19 - $20 | 98% |
| UnitedHealthcare | $19 | 98% |
| Aetna | $19 - $26 | 98% |
| Cigna | $19 - $20 | 98% |
| Cca Senior Care Options | $19 | 98% |
| Magnacare | $20 | 104% |
| Health Partners | $20 | 104% |
| Allegiance | $20 | 104% |
| 1199 National Benefit Fund | $26 | 135% |
| Nippon Life Ins | $26 | 135% |
| Hap | $26 | 135% |
| Webtpa | $26 | 135% |
| Gravie Admin Services | $26 | 135% |
| Meritain | $26 | 135% |
| Luminare Health | $26 | 135% |
| Allied Benefit Systems | $26 | 135% |
| Claimdoc | $41 | 212% |
| Diversified Administrators | $41 | 212% |
| Innovative Health Plan II | $41 | 212% |
| Blue Shield - PA (Highmark) | $78 | 404% |
| Blue Shield - Ny Highmark Western | $78 | 404% |
| Blue Shield - Id (Regence) | $78 | 404% |
| Blue Benefit Administrators of Massachusetts | $78 | 404% |
| Unicare | $78 | 404% |
| Pre-Employment | $78 | 404% |
| Wc Domestic | $78 | 404% |
| Blue Shield - Wa (Regence) | $78 | 404% |
| Kaiser Domestic | $78 | 404% |
| Health Choices | $78 | 404% |
| Blue Shield - Ny Highmark Northeastern | $78 | 404% |
| Blue Shield - Ca | $78 | 404% |
| Blue Distinction Transplant | $78 | 404% |
| Bcn Domestic | $78 | 404% |
| Blue Care Network | $78 | 404% |
| Health New England | $83 | 430% |
| Trinity Health Share | $107 | 554% |
| International Benefit Administrators | $107 | 554% |
| Manhattan Life | $107 | 554% |
| Paramount HMO | $107 | 554% |
| Medi Share | $107 | 554% |
| Pan-American Life | $107 | 554% |
| Asrm - Reliance Standard Life Insurance | $107 | 554% |
| Dean Health | $107 | 554% |
| Mvp | $107 | 554% |
| Allied National Global Care | $107 | 554% |
| Family Life Insurance Company | $107 | 554% |
| Lifetime Benefit Solutions | $107 | 554% |
| Pai | $107 | 554% |
| Christian Care Ministry | $107 | 554% |
| PHCS | $107 | 554% |
| Multiplan | $107 | 554% |
| Ghc Scw | $107 | 554% |
| Prime Health Services | $126 | 653% |
| Connecticare | $128 - $141 | 663% |
| Health Smart | $133 | 689% |