CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: St Charles Medical Center Prineville

Billing Code: G0103 (HCPCS)

The BaseRate · fair price high confidence
A fair price for this
$30
about 1.6× the $19 Medicare rate · typically $20–$39
modeled estimate · not a bill or quote
Medicare pays $19 Fair price $30 Cash price $67 Hospital's list price $84

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.

6 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 $23 - $77 119%
Blue Cross Blue Shieldmajor $26 - $66 135%
Aetnamajor $23 - $73 119%
Cignamajor $23 - $53 119%
Humanamajor $23 119%
Kaiser Permanentemajor $23 - $73 119%
Devoted Health $23 119%
Health Net $23 - $79 119%
Moda Health $39 - $72 202%
PacificSource $15 - $46 78%
Providence Health Plan $39 - $73 202%
UniCare $23 119%
WellCare $23 119%
+ 66 smaller / regional plans $23 - $84
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 384 Se Combs Flat Road, Prineville, OR 97754
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals