CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Ohio Valley Surgical Hospital

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0103
  • Insurance Median: $11,885
  • Cash Discount Price: $122
  • vs. Medicare Baseline: 615.48x Medicare
The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Ohio Valley Surgical Hospital is $11,885. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 615.48x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$122

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,885

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: $122 (632%)
Insurance Median: $11,885 (61548%)
Cash: $122 (632% of Medicare)
Ins. Median: $11,885 (61548% 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 61548% of the Medicare baseline (a markup of 61448%). 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
UnitedHealthcare $23 - $17,571 119%
Nippon Life $27 - $20,896 140%
Aetna $27 - $20,896 140%
Genworth $27 - $20,896 140%
Ngs Coresource $27 - $20,896 140%
Meritain $27 - $20,896 140%
Pacific Source $27 - $20,896 140%
Mail Handlers $27 - $20,896 140%
Meritain Heatlh $27 - $20,896 140%
Geha $27 - $20,896 140%
Mhbp $27 - $20,896 140%
Personify Health $27 - $20,896 140%
Mmoh $92 - $11,885 476%
Mmo Cin. HMO $94 - $129 487%
Mmoh (Supermed) $94 - $95 487%
Medicare (plans) $122 - $12,264 632%
Medben $184 953%
Luminare Health $184 953%
Preferred Health $184 953%
Ohio Health $184 953%
Blue Cross Blue Shield $201 - $40,293 1041%
Medicaid / KanCare $3,557 - $17,827 18421%
Amerihealth Caritas of Ohio $3,657 18938%
Buckeye Community Health Plan $4,022 20829%
Molina McD $4,084 21150%
Caresource $4,364 - $17,827 22600%
Humana $4,493 - $11,919 23268%
Champus $11,885 61548%
American Continental Life $11,885 61548%
Molina McR $11,885 61548%
Molina $11,885 61548%
Communicare Advantage $11,885 61548%
American Retirement $11,885 61548%
Everest $11,885 61548%
Medigold $11,885 61548%
Gateway Health Plan $11,885 61548%
Bankers Fidelity $11,885 61548%
Wellcare By Allwell $11,885 61548%
Molina Dual McR $11,885 61548%
American Continental Insurance $11,885 61548%
Patient No Pay $11,885 61548%
Molina Marketplace $11,885 61548%
Prosperity Supplement $11,885 61548%
Molina Dual McR $11,885 61548%
Molina McR+McD $11,885 61548%
Bankers Life and Casualty $11,885 61548%
Aarp Supplemental $11,885 61548%
American Republic $11,885 61548%
Cigna $11,885 - $18,817 61548%
Aarp $11,885 61548%
Molina McR McD $11,885 61548%
Central States $11,885 61548%
Wraparound Pl Supp $11,885 61548%
Self Pay Imaging $11,885 61548%
Aultcare Primetime Health Plan $11,885 61548%
The Health Plan $12,479 64625%
Devoted Health $13,707 70984%
Employer Direct $15,703 81321%
Golden Rule $17,571 90994%
Surest $17,571 90994%
Oxford $17,571 90994%
Ushealth $17,571 90994%
Medica $17,571 90994%
Shl $17,571 90994%
Caresourse $17,827 92320%
Samba $18,817 97447%
Nalc $18,817 97447%
Sbma $18,817 97447%
Healthgram $18,817 97447%
Unified Group $18,817 97447%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals