CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Grossmont Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $16
Cash Discount Price: $15
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Grossmont Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 0.87x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$15

Average discount available for prompt cash payment at this facility.

Insurance Median

$16

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: $15 (82%)

Insurance Median: $16 (87%)

Cash: $15 (82% of Medicare)

Ins. Median: $16 (87% 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
Blue Cross Blue Shield	$2 - $110	11%
Blue Shield	$2 - $99	11%
Health Net	$2 - $110	11%
Medi-Cal	$2 - $83	11%
UnitedHealthcare	$2 - $101	11%
Aetna	$3 - $113	16%
Allianz Global Assistance	$3 - $110	16%
Cigna	$3 - $118	16%
Indian Health Council	$3 - $90	16%
Epic Americas	$4 - $96	22%
Medicare (plans)	$4 - $110	22%
Community Health Group	$5 - $110	27%
Molina	$5 - $110	27%
San Diego Pace	$5 - $18	27%
Humana	$6 - $44	33%
Multiplan	$8 - $144	44%
Managed Health Network	$13 - $44	71%
County Medical Services	$15 - $83	82%
Interplan	$44 - $113	239%
Kaiser	$83 - $99	451%

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 $15.
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 Grossmont 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.