CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Adventist Health Lodi Memorial

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $24
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Adventist Health Lodi Memorial is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.31x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$16

Average discount available for prompt cash payment at this facility.

Insurance Median
$24

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: $16 (87%)
Insurance Median: $24 (131%)
Cash: $16 (87% of Medicare)
Ins. Median: $24 (131% 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.

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
Medcore(Omni Ipa) Op Only- All Plans $4 - $169 22%
Blue Shield Epn - All Other Plans $5 - $211 27%
Blue Shield Non-Epn $5 - $219 27%
Bc Mcal $7 38%
Kaiser Commercial - All Other Plans $7 - $267 38%
UnitedHealthcare $7 - $270 38%
Healthnet- All Other Plans $8 - $320 44%
Networks By Design- All Plans $8 - $326 44%
First Health- All Plans $13 - $534 71%
Multiplan- All Plans $13 - $521 71%
Beech Street- All Plans $15 - $586 82%
Cigna $15 - $586 82%
Three Rivers Provider Network- All Plans $15 - $586 82%
Western Growers- All Plans $15 - $586 82%
Celtic Ins Company - All Plans $16 - $24 87%
Healthnet Mcal $16 - $30 87%
Hp Of San Joaquin Mcal $16 - $26 87%
Hp Of San Joaquin Ppo - All Other Plans $16 - $618 87%
Kaiser Mcal $16 - $21 87%
Medi-Cal $16 - $21 87%
Alignment Health Plan (Ahp)-All Plans $18 98%
Blue Shield Mcare Adv $18 98%
Cca Health Plan Mcr Adv- All Plans $18 98%
Healthnet Mcare $18 98%
Hp Of San Joaquin Mcr Adv $18 98%
Humana $18 98%
Kaiser Mcr Adv $18 98%
Tricare $18 98%
Knnex Health - All Plans $22 120%
Ah Employee Health Plan - All Plans $33 179%
Bright Health - All Plans $37 201%
Aetna $61 332%
Blue Cross Blue Shield $182 - $202 990%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals