CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Bob Wilson Memorial Hospital

Billing Code: G0103 (HCPCS)

The BaseRate · fair price medium confidence
A fair price for this
$72
about 3.8× the $19 Medicare rate · typically $22–$123
modeled estimate · not a bill or quote
Medicare pays $19 Fair price $72 Cash price $68 Hospital's list price $170

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $54 - $142 280%
Blue Cross Blue Shieldmajor $93 482%
Aetnamajor $54 - $136 280%
Humanamajor $54 280%
HealthPartners $160 829%
+ 3 smaller / regional plans $23 - $161
Government programs also on file: Medicare.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 415 N Main Street, Ulysses, KS 67880
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals