HCPCS G0103
Prostate cancer screening; prostate specific antigen test (psa)
Current codeImmunoassay39 hospitals with prices
What Washington hospitals publish for this code
Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $7.79 – $11.54 | $106 | $264 |
| Cascade Medical Center | $95.96 – $144 | $138 | $173 |
| Cascade Valley Hospital | $20.85 – $114 | $91.20 | $114 |
| Coulee Medical Center | — | $145 | $161 |
| Deaconess Medical Center | $7.13 – $7.54 | $81.60 | $204 |
| Harborview Medical Center | — | $96.15 | $137 |
| Island Hospital | $7.35 – $7.98 | — | — |
| Kadlec Regional Medical Center | — | — | — |
| Legacy Salmon Creek Medical Center | — | — | — |
| Mary Bridge Children's Hospital | $7.37 – $7.96 | $30.80 | $77.00 |
| MultiCare Auburn Medical Center | $7.24 – $7.82 | $30.80 | $77.00 |
| MultiCare Covington Medical Center | $7.24 – $7.82 | $30.80 | $77.00 |
| MultiCare Good Samaritan Hospital | $7.40 – $8.00 | $30.80 | $77.00 |
| MultiCare Valley Hospital | $7.07 – $7.49 | $81.60 | $204 |
| Olympic Medical Center | $9.11 – $9.98 | — | — |
| Overlake Hospital Medical Center & Clinics | — | $13.62 – $23.50 | $27.24 – $47.00 |
| PeaceHealth Peace Island Medical Center | — | $50.70 – $96.85 | $78.00 – $149 |
| PeaceHealth Southwest Medical Cente | $20.08 | $201 | $309 |
| PeaceHealth St John Medical Center | $15.06 – $20.28 | $87.75 | $135 |
| PeaceHealth St Joseph Medical Center | $20.28 | $115 | $177 |
| PeaceHealth United General Medical Center | — | $70.85 | $109 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | — | — |
| Providence Centralia Hospital | — | — | — |
| Providence Holy Family Hospital | — | — | — |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Joseph Hospital | — | $106 | $151 |
| Providence St Mary Medical Center | — | — | — |
| Providence St Peter Hospital | — | — | — |
| Skagit Valley Hospital | — | $96.00 | $120 |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | — | — |
| Swedish Medical Center | — | — | — |
| Swedish Medical Center / Cherry Hill | — | — | — |
| Tacoma General Allenmore Hospital | $7.41 – $8.00 | $30.80 | $77.00 |
| Three Rivers Hospital | $153 – $170 | $219 – $243 | $219 – $243 |
| University of Washington Medical Ctr | — | $83.01 | $119 |
| Virginia Mason Medical Center | — | — | — |
| Wellfound Behavioral Health Hospital | — | $58.00 | $145 |
| Yakima Valley Memorial | $7.08 – $8.22 | $30.40 | $76.00 |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Lab fee schedule (national limit)
- $19.31