CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Adventist Health Reedley

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $18
Cash Discount Price: $28
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Adventist Health Reedley is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 0.98x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.

Cash / Self-Pay

$28

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: $28 (152%)

Insurance Median: $18 (98%)

Cash: $28 (152% 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 Medi-Cal	$2 - $56	11%
Blue Shield Epn - All Other Plans	$4 - $165	22%
Healthnet- All Other Plans	$4 - $163	22%
UnitedHealthcare	$4 - $157	22%
Blue Shield Non Epn	$5 - $191	27%
Kaiser - All Other Plans	$5 - $187	27%
Western Growers/Pinnacle- All Plans	$5 - $172	27%
Bc Mcal	$7	38%
Cigna	$7 - $243	38%
Physicians Med Group Op/Profee Only- All Plans	$8 - $299	44%
Cal Viva Hlth Mcal - All Plans	$10 - $21	54%
Community Care Ipa Mcal-All Plans	$10 - $27	54%
Dignity Mcal Op/Profee Only-All Other Plans	$10 - $23	54%
Kern Health Systems Mcal-All Plans	$10 - $21	54%
Medi-Cal	$10 - $21	54%
Blue Shield Mcare	$18	98%
Dignity Mcr Adv Op/Profee Only	$18	98%
Fhcn Pace Mcr Adv-All Plans	$18	98%
Healthnet- Mcr Adv	$18	98%
Kaiser Mcr Adv	$18	98%
Phs Prime Health Srvcs	$18	98%
Tricare	$18	98%
Bright Health Mcr Adv - All Plans	$29	158%
Aetna	$30 - $107	163%
Ah Employee Health Plan - All Plans	$33	179%
Blue Cross Blue Shield	$82 - $235	446%

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 $28.
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 Reedley 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.