CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: St Charles Hospital

Billing Code: G0103 (HCPCS)

The BaseRate · fair price high confidence

A fair price for this

$20

about 1.1× the $19 Medicare rate · typically $19–$40

modeled estimate · not a bill or quote

What this hospital charges insurers

$19

About the fair price

about $1 under the fair price · 1.0× Medicare

Medicare pays $19 Fair price $20 This hospital $19 Hospital's list price $339

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

One of the lower prices — 0 of 8 other NY hospitals charge more for the same procedure.

Cheapest $17 Priciest $19

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

A fair price for a Prostate cancer screening (blood test) is about $20 (about 1.1× the $19 Medicare rate). St Charles Hospital charges insurers about $19 — about the fair price. Located in Port Jefferson, NY.

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	$14 - $220	73%
Blue Cross Blue Shieldmajor	$19 - $68	98%
Aetnamajor	$19 - $288	98%
Cignamajor	$48 - $220	249%
Humanamajor	$20	104%
AmeriHealth	$43	223%
Cigna HealthSpring	$19	98%
Fidelis Care	$14 - $31	73%
Independent Health	$14 - $19	73%
MVP Health Care	$14 - $48	73%
Oscar Health	$139	720%
UniCare	$220	1139%
WellCare	$21	109%
+ 44 smaller / regional plans	$14 - $1,791

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 7 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the HCPCS code on your bill matches exactly: G0103.

Insurance Before you use insurance

Call your insurance company to confirm St Charles Hospital is in-network.
Ask your insurer whether prior approval is required for HCPCS code G0103.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Charles Hospital

Compare: Prostate cancer screening (blood test) at other NY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.