CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Rush Memorial Hospital

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0103
Insurance Median: $301
Cash Discount Price: $337
vs. Medicare Baseline: 15.59x Medicare

The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Rush Memorial Hospital is $301. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $337. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 15.59x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$337

Average discount available for prompt cash payment at this facility.

Insurance Median

$301

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: $337 (1745%)

Insurance Median: $301 (1559%)

Cash: $337 (1745% of Medicare)

Ins. Median: $301 (1559% 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 1559% of the Medicare baseline (a markup of 1459%). 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
Health Net	$132	684%
My True Advantage - All Plans	$139	720%
Caresource McR Adv	$139	720%
UnitedHealthcare	$139 - $360	720%
Humana	$141 - $414	730%
Aetna	$141 - $414	730%
Blue Cross Blue Shield	$144 - $329	746%
Today's Option McR Adv-All Plans	$144	746%
Viant Beech St McR Adv	$144	746%
Caresource Marketplace-All Other Plans	$223	1155%
Phcs-All Plans	$360	1864%
Cigna	$360	1864%
Coventry/First Health-All Plans	$405	2097%
Consumers Life Ins-All Plans	$405	2097%
Sagamore-All Plans	$414	2144%
Siho-All Plans	$414	2144%
Multiplan-All Plans	$418	2165%
Community Health Alliance-All Plans	$423	2191%
Encore Health Services-All Plans	$441	2284%

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 $337.
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 Rush Memorial Hospital 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.