CMS Price Transparency Data

Prostate cancer screening (blood test)

Facility: Seton Medical Center Harker Heights

Billing Code: G0103 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0103
Insurance Median: $192
Cash Discount Price: $49
vs. Medicare Baseline: 9.94x Medicare

The contracted insurance negotiated median rate for a Prostate cancer screening (blood test) at Seton Medical Center Harker Heights is $192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $19.31, this hospital’s rate is 9.94x the Medicare baseline. Located in 850 W Central Texas Expressway, Harker Heights, TX.

Cash / Self-Pay

$49

Average discount available for prompt cash payment at this facility.

Insurance Median

$192

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: $49 (254%)

Insurance Median: $192 (994%)

Cash: $49 (254% of Medicare)

Ins. Median: $192 (994% 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 994% of the Medicare baseline (a markup of 894%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medicaid / KanCare	$34 - $527	176%
Blue Cross Blue Shield	$85 - $364	440%
Healthscope Benefits [2290]	$88	456%
UnitedHealthcare	$88 - $192	456%
Aetna	$91 - $282	471%
Bell County Indigent Health Svc [3530]	$93	482%
Healthcare Highways [2210]	$192	994%
Oncology Patient Assistance Programs [2295]	$192	994%
Selecthealth [3740]	$192	994%
Web Tpa [2115]	$192 - $393	994%
Oscar Exchange [6080]	$214	1108%
First Health [1375]	$282	1460%
Mailhandlers [1595]	$282	1460%
Humana	$322 - $355	1668%
First Care Commercial [1371]	$369	1911%
Allied Benefit Systems Inc [1030]	$393	2035%
Cigna	$426	2206%

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 $49.
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 Seton Medical Center Harker Heights 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.