CMS Price Transparency Data
Blood test, PSA (prostate screen)
Facility: Mercy Hospital Northwest Arkansas
Billing Code: 84153 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 84153
- Insurance Median: $45
- Cash Discount Price: $94
- vs. Medicare Baseline: 2.45x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Mercy Hospital Northwest Arkansas is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 2.45x the Medicare baseline. Located in 2710 South Rife Medical Lane, Rogers, AR.
Cash / Self-Pay
$94
Average discount available for prompt cash payment at this facility.
Insurance Median
$45
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: $94 (511%)
Insurance Median: $45 (245%)
Cash: $94 (511% of Medicare)
Ins. Median: $45 (245% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 245% of the Medicare baseline (a markup of 145%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $16 - $25 | 87% |
| Humana | $16 - $150 | 87% |
| Medicaid / KanCare | $16 - $33 | 87% |
| American Health Advantage Of Mo Mcr [20264] | $18 | 98% |
| Blue Cross Blue Shield | $18 - $23 | 98% |
| Cherokee Nation Health Serv Contracted [320066] | $18 | 98% |
| Cigna | $18 - $47 | 98% |
| Cross Timbers Hospice [20098] | $18 | 98% |
| Dept Of Veteran Affairs Contracted [320106] | $18 | 98% |
| Elara Caring Aspire Hospice Contracted [320433] | $18 | 98% |
| Elara Caring Aspire Hospice [20433] | $18 | 98% |
| Globalhealth Contracted [320145] | $18 | 98% |
| Halo Hcr Inc Hospice Contracted [320432] | $18 | 98% |
| Halo Hcr Inc Hospice [20432] | $18 | 98% |
| Independent Health [20197] | $18 | 98% |
| Jordan Valley Senior Care Pace [20515] | $18 | 98% |
| Kindful Hospice Contracted [320434] | $18 | 98% |
| Kindful Hospice [20434] | $18 | 98% |
| Medical Associates Health [20444] | $18 | 98% |
| Medicare (plans) | $18 - $19 | 98% |
| Mercy Hospice Okc [20252] | $18 | 98% |
| Mercy Interfacility [20513] | $18 - $34 | 98% |
| Pace Of The Ozarks [20518] | $18 | 98% |
| Provider Partners Health Plans Contracted [320450] | $18 | 98% |
| Qual Choice Contracted [320325] | $18 | 98% |
| Spina Bifida Hlthcare Benefit [20506] | $18 | 98% |
| Tribute Health Plan Mcr [20338] | $18 | 98% |
| Tricare | $18 | 98% |
| United Medical Resources Contracted [320454] | $18 | 98% |
| UnitedHealthcare | $18 | 98% |
| Valir Pace [20503] | $18 | 98% |
| Wellfirst Health Mcr [20443] | $18 | 98% |
| St Johns Mercy Rehab Llc Contracted [320359] | $20 | 109% |
| St Johns Mercy Rehab Llc [20359] | $20 | 109% |
| Health Choice Contracted [320166] | $23 | 125% |
| Usable Contracted [320409] | $23 | 125% |
| Aither Health Contracted [320449] | $25 | 136% |
| Edison Health Solutions Contracted [320502] | $25 | 136% |
| Mercy Benefit Admin Contracted [320251] | $25 - $112 | 136% |
| Yuzu Health Contracted [320521] | $25 | 136% |
| Ambetter / Centene | $26 | 141% |
| Arkansas Department Of Health [20036] | $26 | 141% |
| Home State Health Plan Contracted [320187] | $26 | 141% |
| Novasys Contracted [320285] | $26 - $43 | 141% |
| Summit Community Care Contracted [320368] | $26 | 141% |
| Summit Community Care [20368] | $26 | 141% |
| Employers Health Coalition Contracted [320116] | $30 | 163% |
| 90 Degree Benefits Contracted [320436] | $50 - $94 | 272% |
| Show-Me Health Administrators Contracted [320483] | $50 - $94 | 272% |
| First Health Contracted [320128] | $56 | 305% |
| Arkansas Total Care Contracted [320039] | $60 | 326% |
| Arkansas Total Care [20039] | $60 | 326% |
| Auxiant Contracted [320462] | $61 - $122 | 332% |
| Ebms Contracted [320493] | $61 - $112 | 332% |
| Healthlink Contracted [320179] | $61 - $122 | 332% |
| Imagine 360 Contracted [320494] | $61 - $112 | 332% |
| Municipal Health Plan Contracted [320271] | $61 - $112 | 332% |
| Reflect Health Contracted [320492] | $61 - $112 | 332% |
| Benefit Management Contracted [320052] | $66 - $122 | 359% |
| Federal Medical Center Contracted [320127] | $66 - $122 | 359% |
| Insurance System Inc Contracted [320465] | $66 - $122 | 359% |
| Personify Health Contracted [320051] | $66 - $122 | 359% |
| Point C Contracted [320238] | $66 - $122 | 359% |
| Preferred Health Plan Contracted [320522] | $66 - $122 | 359% |
| Tri State Healthcare Coalition Contracted [320379] | $66 - $122 | 359% |
| Workers Comp [20426] | $66 - $122 | 359% |
| Private Health Care Systems Contracted [320320] | $74 - $137 | 402% |
| Private Health Care Systems [20320] | $74 - $137 | 402% |
| Ppo Plus Contracted [320310] | $76 - $140 | 413% |
| Healthscope Contracted [320182] | $81 - $150 | 440% |
| Qual Choice Contracted [320324] | $81 | 440% |
| Multiplan Contracted [320270] | $86 - $159 | 468% |
| Multiplan [20270] | $86 - $159 | 468% |