CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Community Memorial Hospital - Ventura

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $18
Cash Discount Price: $42
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Community Memorial Hospital - Ventura is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 0.98x the Medicare baseline. Located in 147 North Brent Street, Ventura, CA.

Cash / Self-Pay

$42

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: $42 (228%)

Insurance Median: $18 (98%)

Cash: $42 (228% 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
Valley Care	$3 - $31	16%
Ventura County Health Care Plan	$4 - $31	22%
Gold Coast Health Plan	$6 - $43	33%
Medicaid / KanCare	$6 - $43	33%
Multiplan	$10 - $74	54%
Seaview	$15	82%
Aetna	$16 - $125	87%
Alignment Health Plan	$16 - $19	87%
Blue Cross Blue Shield	$16 - $25	87%
California Workers Compensation	$16 - $18	87%
Health Net Commercial	$16 - $76	87%
Medi-Cal	$16 - $23	87%
Medicare (plans)	$16 - $19	87%
Non Contracted	$16 - $18	87%
Scan Health Plan	$16 - $19	87%
Tricare	$16 - $19	87%
UnitedHealthcare	$16 - $32	87%
Wellcare Of California	$16 - $18	87%
Humana	$17 - $19	92%
Cigna	$24	131%
Kaiser Commercial	$66	359%
Blue Shield Epn	$72	392%
Blue Shield Commercial	$81	440%

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 $42.
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 Community Memorial Hospital - Ventura 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.