Blood test, PSA (prostate screen)
Facility: AHMC Seton Medical Center
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $97
- Cash Discount Price: $306
- vs. Medicare Baseline: 5.27x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 527% of the Medicare baseline (a markup of 427%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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 (Va) | $13 | 71% |
| Medi-Cal | $16 | 87% |
| Aetna | $18 - $56 | 98% |
| Apcmg | $18 - $28 | 98% |
| Asian American Medical Group | $18 - $23 | 98% |
| Blue Cross Blue Shield | $18 - $294 | 98% |
| Blue Shield Of California | $18 - $234 | 98% |
| Brand New Day | $18 - $23 | 98% |
| Brown And Toland Medical Group | $18 - $23 | 98% |
| Canopy Health | $18 - $33 | 98% |
| Care Advantage | $18 | 98% |
| Chinese Community Health Plan | $18 - $194 | 98% |
| Cmac | $18 | 98% |
| Covid-19 Uninsured Program | $18 | 98% |
| For Your Benefit | $18 | 98% |
| Healthnet Seniority | $18 | 98% |
| Hill Physicians Medical Group Inc | $18 - $21 | 98% |
| Humana | $18 | 98% |
| Imperial Health Plan | $18 | 98% |
| Jade Health Care Mg | $18 - $194 | 98% |
| Kaiser | $18 - $317 | 98% |
| Medicare (plans) | $18 | 98% |
| North East Medical Services | $18 - $23 | 98% |
| Pacificare | $18 | 98% |
| UnitedHealthcare | $18 - $37 | 98% |
| Central Health Plan | $19 | 103% |
| Easy Choice Hospital Services | $19 | 103% |
| San Mateo County/San Mateo County General Hospital | $20 | 109% |
| Athens Administrators | $22 | 120% |
| Corvel Healthcare | $22 | 120% |
| Multiplan/Bce Emergis | $22 - $290 | 120% |
| Tricare | $22 | 120% |
| Work Comp Other | $22 | 120% |
| Ahmc Health | $23 | 125% |
| Health Plan Of San Mateo Healthworx | $23 | 125% |
| Knox-Keene Act | $23 | 125% |
| San Francisco Health Plan | $23 | 125% |
| Health Plan Of San Mateo | $26 | 141% |
| Self Pay | $57 - $132 | 310% |
| Cigna | $97 | 527% |
| Interplan Corporation | $227 - $232 | 1234% |
| Healthcare Foundation Of San Mateo | $265 - $290 | 1441% |
| Private Healthcare Sytems Inc | $284 - $290 | 1544% |
| The First Health Network | $284 - $290 | 1544% |
| Health Net | $291 - $297 | 1582% |
| Beech Street Corporation | $303 - $310 | 1648% |
| Choicecare Network | $322 - $329 | 1751% |
| Multiplan | $322 - $329 | 1751% |
| Mills Peninsula Health Services | $341 - $348 | 1854% |
| Indemnity | $379 - $387 | 2061% |
| Workers Compensation Federal | $379 - $387 | 2061% |