CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Jacobson Memorial Hospital Care Center

Billing Code: G0103 (HCPCS)

The BaseRate · fair price medium confidence
A fair price for this
$103
about 5.4× the $19 Medicare rate · typically $25–$153
modeled estimate · not a bill or quote
Medicare pays $19 Fair price $103 Cash price $97 Hospital's list price $129

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.

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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 $98 - $129 508%
Blue Cross Blue Shieldmajor $129 - $181 668%
Aetnamajor $77 - $129 399%
Cignamajor $116 601%
Humanamajor $129 668%
HealthPartners $116 601%
Medica $103 533%
Sanford Health Plan $129 668%
+ 2 smaller / regional plans $103 - $129
Government programs also on file: Medicare, Medicaid, Military & VA.
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: 601 East St N, Elgin, ND 58533
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals