CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Riverside Community Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $21
Cash Discount Price: $1,262
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Riverside Community Hospital is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,262. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.14x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.

Cash / Self-Pay

$1,262

Average discount available for prompt cash payment at this facility.

Insurance Median

$21

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: $1,262 (6862%)

Insurance Median: $21 (114%)

Cash: $1,262 (6862% of Medicare)

Ins. Median: $21 (114% 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
Bristol Hospice	$15	82%
Aetna	$18 - $227	98%
Alignment Health Plan	$18	98%
Blue Cross Blue Shield	$18 - $96	98%
Blue Shield	$18 - $202	98%
Brand New Day	$18 - $23	98%
Central Health Plan	$18	98%
Clever Care Of Golden State	$18	98%
Easy Choice Health Plan	$18	98%
Heritage Provider Network	$18 - $25	98%
Humana	$18	98%
Redlands Community Hospital	$18	98%
Riverside Medical Clinic	$18 - $22	98%
Riverside Physician	$18	98%
Scan Health Plan	$18	98%
Triwest Healthcare Alliance	$18	98%
United	$18 - $332	98%
UnitedHealthcare	$18	98%
Care1St Health Plan	$19	103%
Health Net	$19 - $281	103%
Corvel Corporation	$21	114%
La Care Health	$21	114%
Molina	$21	114%
Healthsmart	$22 - $1,009	120%
Next	$22 - $1,009	120%
Inland Empire Health Plan	$31	169%
Bright Health	$46	250%
Cigna	$51	277%
Medcare Partners	$189	1028%
First Health	$555 - $1,136	3018%
American Health System	$568	3089%
Multiplan	$1,009 - $1,072	5487%

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 $1,262.
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 Riverside Community Hospital 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.