CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: St Joseph's University Medical Center Inc

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0103
  • Insurance Median: $39
  • Cash Discount Price: $167
  • vs. Medicare Baseline: 2.02x Medicare
The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at St Joseph's University Medical Center Inc is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $167. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 2.02x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$167

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $167 (865%)
Insurance Median: $39 (202%)
Cash: $167 (865% of Medicare)
Ins. Median: $39 (202% 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 202% of the Medicare baseline (a markup of 102%). 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
Aetna $19 - $39 98%
Amerihealth $19 - $106 98%
Blue Cross Blue Shield $19 - $146 98%
Clover Health $19 98%
Horizon New Jersey Total Care $19 98%
UnitedHealthcare $19 - $40 98%
Wellpoint $19 - $33 98%
Fidelis Care of New Jersey $20 - $33 104%
Longevity Health Plan $22 114%
Ambetter / Centene $29 150%
Oxford $40 207%
Horizon New Jersey Health $88 456%
Private Healthcare Systems $109 564%
Magnacare $117 606%
Multiplan $125 647%
Consumer Health Network $150 777%
Oscar $157 813%
Cigna $167 865%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 703 Main St, Paterson, NJ 07503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals