CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: University Medical Center of Princeton at Plainsboro

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0103
  • Insurance Median: $333
  • Cash Discount Price: $573
  • vs. Medicare Baseline: 17.24x Medicare
The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at University Medical Center of Princeton at Plainsboro is $333. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $573. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 17.24x the Medicare baseline. Located in One-Five Plainsboro Road, Plainsboro, NJ.
Cash / Self-Pay
$573

Average discount available for prompt cash payment at this facility.

Insurance Median
$333

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: $573 (2967%)
Insurance Median: $333 (1724%)
Cash: $573 (2967% of Medicare)
Ins. Median: $333 (1724% 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 1724% of the Medicare baseline (a markup of 1624%). 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
Blue Cross Blue Shield $19 - $431 98%
UnitedHealthcare $19 - $29 98%
VA Medical Center $19 98%
Medicare (plans) $19 - $21 98%
Aetna $19 - $477 98%
Cigna $20 - $573 104%
Clover Health Plan $20 104%
Humana $21 109%
Tricare $23 119%
Us Family Health Plan $23 119%
Elap $27 - $35 140%
Horizon Nj Health $28 145%
Claim Watcher $35 181%
Centivo $35 181%
Amerihealth $50 259%
Medicaid / KanCare $53 - $573 274%
Charity Care $54 280%
Wellcare $58 300%
Preferred Health Care Eliance $149 772%
Horizon Behavioral Health $215 1113%
Beacon Health Options $286 1481%
Magnacare $344 - $401 1781%
Princeton Theological Seminary $372 1926%
Coventry $401 2077%
Health Net $401 2077%
Beech Street $458 - $487 2372%
Intergrated Health Plan $458 2372%
Intergroup $458 2372%
Penn Global Medicine Embassy Only $458 2372%
Ie Shaffer $487 2522%
Tri-State $487 2522%
Private Healthcare Systems $487 2522%
Qualcare $487 2522%
First Managed Care Option $487 2522%
Allied Trades $487 2522%
Devon Health Services $487 2522%
Total Care Network $487 2522%
Consumer Health Network $487 2522%
Personnel Health Program $573 2967%
United Behavioral Health $573 2967%
Penn Behavioral Health Corporate Services $573 2967%
International Pfs $573 2967%
Compsych $573 2967%
Magellan $573 2967%
Concern Plus $573 2967%
Nj Carpenters $573 2967%
Managed Health Network $573 2967%
Commercial Other $573 2967%
Life St. Francis $573 2967%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One-Five Plainsboro Road, Plainsboro, NJ 08536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals