CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Raritan Bay Medical Center

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0103
  • Insurance Median: $224
  • Cash Discount Price: $19
  • vs. Medicare Baseline: 11.60x Medicare
The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Raritan Bay Medical Center is $224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 11.60x the Medicare baseline. Located in 530 New Brunswick Ave, Perth Amboy, NJ.
Cash / Self-Pay
$19

Average discount available for prompt cash payment at this facility.

Insurance Median
$224

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: $19 (98%)
Insurance Median: $224 (1160%)
Cash: $19 (98% of Medicare)
Ins. Median: $224 (1160% 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 1160% of the Medicare baseline (a markup of 1060%). 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
Amerigroup $19 - $21 98%
Clover $19 98%
Seoul Medical Group $19 98%
Vaccn $19 98%
Wellcare $19 98%
United Community/Americhoice $20 104%
Aetna $21 - $254 109%
UnitedHealthcare $23 - $40 119%
Karna $26 135%
Oxford $40 207%
Cigna $88 - $260 456%
Qualcare $216 - $295 1119%
Activecare First McO $244 1264%
Bergen Risk $244 1264%
Horizon $248 - $314 1284%
Brighton Health Plan $260 1346%
Multiplan - PHCS $276 1429%
Amerihealth $281 - $316 1455%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 New Brunswick Ave, Perth Amboy, NJ 08861
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals