CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Harmon Memorial Hospital

Billing Code: G0103 (HCPCS)

The BaseRate · fair price medium confidence
A fair price for this
$43
about 2.3× the $19 Medicare rate · typically $16–$99
modeled estimate · not a bill or quote
Medicare pays $19 Fair price $43 Cash price $58 Hospital's list price $58

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Aetna✓ Humana UnitedHealthcareCignaKaiser 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
Blue Cross Blue Shieldmajor $46 238%
Aetnamajor $41 - $46 212%
Humanamajor $41 212%
+ 1 smaller / regional plan $41 - $49
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 400 East Chestnut Street, Hollis, OK 73550
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals