CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Sunrise Hospital and Medical Center

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0103
Insurance Median: $19
Cash Discount Price: $78
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Sunrise Hospital and Medical Center is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 0.98x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.

Cash / Self-Pay

$78

Average discount available for prompt cash payment at this facility.

Insurance Median

$19

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: $78 (404%)

Insurance Median: $19 (98%)

Cash: $78 (404% of Medicare)

Ins. Median: $19 (98% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$3 - $32	16%
Cigna	$5 - $50	26%
United	$8 - $567	41%
Blue Cross Blue Shield	$9 - $24	47%
Sierra	$13 - $32	67%
Humana	$14 - $28	73%
Ambetter / Centene	$19 - $20	98%
Alignment Health Plan	$19	98%
Health Net	$19	98%
Hometown Health McR	$19	98%
Triwest Healthcare Alliance	$19	98%
Select Health	$19 - $626	98%
Caremore	$20	104%
Health Services Coalition	$20	104%
Imperial Nv	$21	109%
Universal Healthcare	$23	119%
Prominence Healthfirst	$814	4215%
Cmn Global	$1,140	5904%
Hometown Health Providers	$1,357	7027%
Nv Health & Welfare Trust	$1,628	8431%
Multiplan	$1,710 - $1,981	8856%
First Health	$1,791 - $2,171	9275%
Medcare International	$2,036	10544%
Olympus Medsave USA	$2,036	10544%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $78.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0103.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sunrise Hospital and Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0103.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.