CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Lafayette Regional Health Center

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0103
  • Insurance Median: $219
  • Cash Discount Price: $473
  • vs. Medicare Baseline: 11.34x Medicare
The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Lafayette Regional Health Center is $219. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $473. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 11.34x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$473

Average discount available for prompt cash payment at this facility.

Insurance Median
$219

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: $473 (2450%)
Insurance Median: $219 (1134%)
Cash: $473 (2450% of Medicare)
Ins. Median: $219 (1134% 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 1134% of the Medicare baseline (a markup of 1034%). 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
United $19 - $213 98%
Ambetter / Centene $88 456%
Nhc Advantage $90 466%
Healthyblue $95 492%
Aetna $123 - $414 637%
Universal Healthcare $123 637%
Humana $160 - $203 829%
Blue Cross Blue Shield $180 - $473 932%
College Park Family Care Center $203 1051%
Oscar $236 1222%
Oha Network $236 1222%
Cigna $270 - $338 1398%
Wppa Providrs Care Network $355 1838%
Multiplan $369 1911%
Coventry $377 1952%
Coventry Kc Mo $377 1952%
Corvel Corporation $402 2082%
Cco, Inc. $402 2082%
Focus Healthcare Mgmt, Inc $425 2201%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals