Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HCHG PSA-SCREEN
Ulm, MN
See all hospitals reporting HCPCS G0103 →Price type
Allina Health Systems’s median price of $44 is 36% above the median hospital's median price ($33), higher than 61% of the 2,306 hospitals reporting HCPCS G0103. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 25 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $11 | $17 | $10 | 59% | — | $9 – $31 |
| 2 | Aetna allina aetna medicare (n) facility · fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 3 | Medicare medicare (n) facility · fee schedule · outpatient | $19 | $19 | — | — | — | $19 – $19 |
| 4 | Bcbs Mn bc pmap (n) facility · other · outpatient | $23 | $23 | — | — | 28 | $23 – $23 |
| 5 | Medica medica pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $18 | $27 | $16 | 59% | — | $14 – $50 |
| 6 | Medicaid medicaid ma (n) facility · other · outpatient | $25 | $37 | $22 | 59% | 1–10 | $19 – $68 |
| 7 | Medica medica medicare (r) facility · fee schedule · outpatient | $25 | $38 | $22 | 59% | — | $20 – $69 |
| 8 | Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges | $25 | $38 | $23 | 59% | — | $20 – $70 |
| 9 | Blue Cross Blue Shield bc medicare (n) facility · fee schedule · outpatient | $26 | $40 | $23 | 59% | — | $20 – $72 |
| 10 | Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges | $35 | $52 | $31 | 59% | — | $27 – $96 |
| 11 | Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges | $35 | $53 | $31 | 59% | — | $27 – $97 |
| 12 | Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges | $37 | $57 | $33 | 59% | — | $29 – $103 |
| 13 | Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges | $38 | $57 | $34 | 59% | — | $29 – $104 |
| 14 | Medica medica ubh (n) facility · percent of total billed charges · inpatientfrom % of charges | $39 | $60 | $35 | 59% | — | $31 – $109 |
| 15 | Medica medica ubh pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $45 | $68 | $40 | 59% | — | $35 – $125 |
| 16 | Cigna hpi cigna (n) facility · other · outpatient | $46 | $70 | $41 | 59% | 39 | $36 – $128 |
| 17 | Bcbs Mn bc state health plan (n) facility · other · outpatient | $71 | $71 | — | — | 38 | $71 – $71 |
| 18 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $47 | $72 | $42 | 59% | — | $37 – $131 |
| 19 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $47 | $72 | $42 | 59% | — | $37 – $131 |
| 20 | Medica medica ubh (n) facility · percent of total billed charges · outpatientfrom % of charges | $47 | $72 | $42 | 59% | — | $37 – $131 |
| 21 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · inpatientfrom % of charges | $48 | $72 | $42 | 59% | — | $37 – $132 |
| 22 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · outpatientfrom % of charges | $48 | $73 | $43 | 59% | — | $38 – $133 |
| 23 | Bcbs Mn bc premier(n) facility · other · outpatient | $91 | $91 | — | — | 13 | $91 – $91 |
| 24 | Blue Cross Blue Shield bc aehp (n) facility · other · outpatient | $107 | $107 | — | — | 26 | $107 – $107 |
| 25 | Bcbs Mn bc high value/performance network (n) facility · other · outpatient | $115 | $115 | — | — | 76 | $115 – $115 |
Last updated: Jun 16, 2026
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