Prostate cancer screening; digital rectal examination
Medicare pricing data for 1,273 providers across 40 states
Prices vary significantly by location — from $9 in Maine to $27 in New York. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Prostate cancer screening; digital rectal examination (HCPCS code G0102) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $23.36, but hospitals typically charge $50.88 — a 2.2x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $23.36, your out-of-pocket cost would be approximately $4.67. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $13.46 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New York | $27 | $106 | 97 | 833 | +14.2% |
| Maryland | $27 | $61 | 7 | 12 | +13.6% |
| New Jersey | $26 | $32 | 28 | 366 | +11.6% |
| California | $26 | $49 | 131 | 1,272 | +10.6% |
| Washington | $25 | $56 | 51 | 221 | +8.3% |
| Connecticut | $25 | $41 | 9 | 43 | +7.6% |
| Massachusetts | $25 | $68 | 165 | 996 | +6.7% |
| Virginia | $25 | $40 | 34 | 279 | +5.4% |
| Illinois | $24 | $61 | 40 | 634 | +2.9% |
| Rhode Island | $24 | $38 | 9 | 82 | +2.1% |
| Colorado | $24 | $46 | 45 | 246 | +2.0% |
| Pennsylvania | $24 | $40 | 33 | 375 | +1.1% |
| Delaware | $23 | $34 | 5 | 37 | -0.1% |
| Nevada | $23 | $59 | 7 | 94 | -0.9% |
| Vermont | $23 | $65 | 3 | 12 | -3.0% |
| Texas | $22 | $41 | 91 | 842 | -4.9% |
| Arizona | $22 | $44 | 66 | 524 | -5.7% |
| Florida | $22 | $44 | 57 | 487 | -6.1% |
| Michigan | $22 | $35 | 45 | 542 | -6.3% |
| Oregon | $22 | $46 | 20 | 49 | -6.4% |
| Kansas | $22 | $27 | 14 | 325 | -7.3% |
| North Carolina | $22 | $50 | 44 | 352 | -7.3% |
| South Carolina | $22 | $30 | 16 | 250 | -7.5% |
| Nebraska | $22 | $51 | 7 | 13 | -7.7% |
| Iowa | $21 | $34 | 34 | 148 | -8.3% |
| Ohio | $21 | $50 | 23 | 229 | -8.6% |
| New Mexico | $21 | $43 | 3 | 14 | -8.9% |
| Utah | $21 | $41 | 7 | 14 | -8.9% |
| Missouri | $21 | $33 | 10 | 34 | -9.4% |
| Tennessee | $21 | $34 | 34 | 256 | -9.6% |
| Louisiana | $21 | $25 | 4 | 20 | -10.0% |
| Indiana | $21 | $39 | 24 | 53 | -11.3% |
| Mississippi | $21 | $39 | 2 | 17 | -11.4% |
| Kentucky | $21 | $34 | 8 | 42 | -11.4% |
| Georgia | $21 | $31 | 24 | 136 | -11.9% |
| Alabama | $20 | $37 | 12 | 39 | -13.1% |
| West Virginia | $20 | $34 | 5 | 18 | -13.4% |
| Wisconsin | $13 | $78 | 19 | 60 | -45.7% |
| New Hampshire | $10 | $43 | 18 | 148 | -55.2% |
| Maine | $9 | $23 | 2 | 17 | -63.1% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber