CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Baldwin Health

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $27
  • Cash Discount Price: $272
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Baldwin Health is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $272. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.47x the Medicare baseline. Located in 1613 North McKenzie Street, Foley, AL.
Cash / Self-Pay
$272

Average discount available for prompt cash payment at this facility.

Insurance Median
$27

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$18.39

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $18.39 (100%)
Cash / Self-Pay: $272 (1479%)
Insurance Median: $27 (147%)
Cash: $272 (1479% of Medicare)
Ins. Median: $27 (147% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $18.39 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
First Choice $10 54%
Medicaid / KanCare $13 71%
Bc Pml $15 82%
Tricare $15 82%
Node Champva $16 87%
Blue Cross Blue Shield $17 - $18 92%
UnitedHealthcare $17 - $18 92%
Cigna $18 - $76 98%
Community Hospice $18 98%
Hospice $18 98%
Humana $18 98%
Medicare (plans) $18 98%
Mercy Medical Hospice $18 98%
Node Devoted Health Mcr Adv $18 98%
Node Va $18 98%
Triwest $18 98%
Veterans Eval Services $18 98%
Windsor Health Plan $18 98%
Aetna $19 - $1,021 103%
Node Clover Health Mcr Adv $19 103%
Node Wellcare Mcr Adv $19 103%
Select Health $19 103%
Us Dol $23 125%
Ambetter / Centene $28 152%
Self Pay $204 - $340 1109%
American Employee Alliance $454 2469%
Multiplan $647 - $930 3518%
First Health $851 - $916 4628%
Alamed $868 4720%
Multiplan Inc $868 4720%
Coventry Work Comp Al $887 4823%
One Health $908 4937%
Pro America $908 4937%
Novanet $916 4981%
Alabama Wc $964 5242%
Gulf Health $964 5242%
Principal Ppo $964 5242%
Viva Health $964 5242%
National Health $1,021 5552%
Galaxy $1,032 5612%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1613 North McKenzie Street, Foley, AL 36535
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals