CMS Price Transparency Data
Blood test, PSA (prostate screen)
Facility: San Gabriel Valley Medical Center
Billing Code: 84153 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 84153
- Insurance Median: $22
- Cash Discount Price: $94
- vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at San Gabriel Valley Medical Center is $22. 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 1.20x the Medicare baseline. Located in 438 W Las Tunas Drive, San Gabriel, CA.
Cash / Self-Pay
$94
Average discount available for prompt cash payment at this facility.
Insurance Median
$22
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: $22 (120%)
Cash: $94 (511% of Medicare)
Ins. Median: $22 (120% 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
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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 |
|---|---|---|
| Veterans Administration | $13 | 71% |
| Ahmc Medi-Cal Reciprocity | $16 | 87% |
| Allied Physicians | $16 - $28 | 87% |
| Altamed Health Network | $16 - $18 | 87% |
| Beverly Hospital | $16 - $20 | 87% |
| Brand New Day | $16 - $110 | 87% |
| Emanate Health | $16 - $23 | 87% |
| Healthnet Medi-Cal Non-Contract | $16 | 87% |
| Healthy Way La | $16 | 87% |
| Non Contracting Medi Cal | $16 | 87% |
| Aetna | $18 - $32 | 98% |
| Aids Healthcare Foundation | $18 - $126 | 98% |
| Alignment Health Plan | $18 | 98% |
| Apa/Aco Inc | $18 | 98% |
| Avanti | $18 - $22 | 98% |
| Blue Cross Blue Shield | $18 - $89 | 98% |
| Blue Shield Of California | $18 - $259 | 98% |
| Central Health Plan | $18 - $188 | 98% |
| Cv-19 Hrsa Uninsured Testing And Tx | $18 | 98% |
| Health Net | $18 - $182 | 98% |
| Health Net Inc | $18 - $43 | 98% |
| Hollywood Presbyterian Adv Med Mcal | $18 | 98% |
| Hollywood Presbyterian Medpoint Mcal | $18 | 98% |
| Humana | $18 | 98% |
| Inter Valley Health Plan | $18 | 98% |
| La Care Health Plan | $18 - $19 | 98% |
| Medicaid / KanCare | $18 | 98% |
| Medicare (plans) | $18 | 98% |
| Molina Healthcare Of California | $18 - $122 | 98% |
| Pacific Alliance Medical Center | $18 | 98% |
| Pacificare Of California | $18 - $103 | 98% |
| Physicians Healthways | $18 | 98% |
| Providence Health Network | $18 | 98% |
| Self-Pay | $18 | 98% |
| St Vincent Medical Center/Psych | $18 | 98% |
| Tricare | $18 | 98% |
| Wellcare | $18 | 98% |
| Cigna | $21 | 114% |
| Athens Administrators | $22 | 120% |
| Beech Street | $22 - $251 | 120% |
| Chinatown Service Center Pace | $22 | 120% |
| Other Non Contracting Workers Comp | $22 | 120% |
| Ahmc Health Self-Insurance Epo | $23 | 125% |
| Care 1St Health Plan | $23 - $204 | 125% |
| Knox-Keene Act | $23 | 125% |
| UnitedHealthcare | $37 - $74 | 201% |
| Private Pay | $54 | 294% |
| Ahmc Reciprocity | $94 | 511% |
| Alignment Healthplan | $110 | 598% |
| Clever Care | $110 | 598% |
| Pacific Independent Physician Associates | $126 | 685% |
| Facey Medical | $157 | 854% |
| Community Care Network | $204 | 1109% |
| Choicecare Network | $220 | 1196% |
| Private Healthcare Systems (Phcs) | $220 | 1196% |
| Affiliated Health Fund | $236 | 1283% |
| Multiplan | $283 | 1539% |
| Ppo Next | $283 | 1539% |
| Managed Health Network | $314 | 1707% |
| Medi-Cal Sub Acute | $314 | 1707% |
| One Legacy | $314 | 1707% |
| Other Non Contracted Commercial | $314 | 1707% |
| Us Behavioral Health Plan | $314 | 1707% |