CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Adventist Health St Helena

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $18
Cash Discount Price: $24
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Adventist Health St Helena is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 0.98x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$24

Average discount available for prompt cash payment at this facility.

Insurance Median

$18

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: $24 (131%)

Insurance Median: $18 (98%)

Cash: $24 (131% of Medicare)

Ins. Median: $18 (98% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Healthnet-All Plans	$2 - $58	11%
UnitedHealthcare	$4 - $203	22%
Blue Shield Behav Hlth	$5 - $143	27%
Blue Shield Epn-All Other Plans	$5 - $150	27%
Blue Shield Non-Epn	$5 - $148	27%
Western Growers-All Plans	$5 - $169	27%
Phcs-All Plans	$6 - $175	33%
Choicecare-All Plans	$7 - $223	38%
Interplan-All Plans	$7 - $207	38%
Beech Street-All Plans	$8 - $238	44%
Cigna	$8 - $254	44%
Kaiser-All Other Plans	$8 - $261	44%
Galaxy Network-All Plans	$9 - $286	49%
Health Management Network-All Plans	$9 - $270	49%
Three Rivers-All Plans	$9 - $286	49%
Va Medi-Cal	$10 - $21	54%
Blue Shield Bh Mcr Adv	$18	98%
Blue Shield Mcr Adv	$18	98%
Kaiser Mcr Adv	$18	98%
Tricare	$18	98%
Va Mcr - All Other Plans	$18	98%
Ah Employee Health Plan - All Plans	$33	179%
Aetna	$108	587%
Blue Cross Blue Shield	$159 - $212	865%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $24.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84153.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health St Helena is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84153.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.