CMS Price Transparency Data
Blood test, PSA (prostate screen)
Facility: Clovis Community Medical Center
Billing Code: 84153 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 84153
- Insurance Median: $18
- Cash Discount Price: $81
- vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Clovis Community Medical Center is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 0.98x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
$81
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: $81 (440%)
Insurance Median: $18 (98%)
Cash: $81 (440% 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.
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 |
|---|---|---|
| Central Valley Medical Providers | $6 - $126 | 33% |
| Community Care | $6 - $46 | 33% |
| Employer 90/40 | $9 - $72 | 49% |
| Aetna | $11 - $90 | 60% |
| Blue Shield | $12 - $102 | 65% |
| Central Ca Indian Health | $12 - $99 | 65% |
| Cigna | $12 - $111 | 65% |
| Nx Health Network Ppo | $12 - $99 | 65% |
| UnitedHealthcare | $12 - $94 | 65% |
| Healthnet | $13 - $105 | 71% |
| Blue Cross Blue Shield | $14 - $114 | 76% |
| Healthsmart | $15 - $144 | 82% |
| Cal Caloptima | $16 | 87% |
| Ccs Fresno | $16 | 87% |
| Ccs Kern | $16 | 87% |
| Ccs Kings | $16 | 87% |
| Ccs Madera/Sacramento | $16 | 87% |
| Ccs Mariposa | $16 | 87% |
| Ccs Merced | $16 | 87% |
| Ccs Stanislaus | $16 | 87% |
| Ccs Tulare | $16 | 87% |
| Chdp | $16 | 87% |
| Coventry Health Care (First Health Network) | $16 - $135 | 87% |
| Fresno County Funded Specialty Care | $16 | 87% |
| Generic Care Out Of County | $16 | 87% |
| Generic Ccs Other Counties | $16 | 87% |
| Genetically Handicapped Person | $16 | 87% |
| Gold Coast Medi-Cal | $16 | 87% |
| Medi-Cal Alameda Alliance For Health | $16 | 87% |
| Medi-Cal Blue Shield Promise Health | $16 | 87% |
| Medi-Cal California Health & Wellness Plan | $16 | 87% |
| Medi-Cal Cencal Health | $16 | 87% |
| Medi-Cal Community Health Group | $16 | 87% |
| Medi-Cal Contra Costa Health Plan | $16 | 87% |
| Medi-Cal Health Plan Of San Mateo | $16 | 87% |
| Medi-Cal Inland Empire Health | $16 | 87% |
| Medi-Cal Kern Family Health | $16 | 87% |
| Medi-Cal La Care Health | $16 | 87% |
| Medi-Cal Molina | $16 | 87% |
| Medi-Cal Partnership Health Plan Of Ca | $16 | 87% |
| Network By Design | $16 - $135 | 87% |
| San Francisco Health Plan Medi-Cal | $16 | 87% |
| Santa Clara Family Health Plan - Premier Health | $16 | 87% |
| Santa Clara Family Health Plan - Valley Health | $16 | 87% |
| Advantek Table Mountain Rancheria Tribal Member | $18 | 98% |
| Blue Shield 65 Plus Hmo Ehs | $18 | 98% |
| Blue Shield 65 Plus Hmo First Choice | $18 | 98% |
| Blue Shield Hmo-Cvmp/Medpro | $18 | 98% |
| Blue Shield Promise - Imperial | $18 | 98% |
| Blue Shield Saint Agnes | $18 | 98% |
| Blue Shield Sante | $18 | 98% |
| Brand New Day | $18 | 98% |
| Bscphp - Dhmso | $18 | 98% |
| Bscphp - First Choice | $18 | 98% |
| Bscphp Hmo - First Choice | $18 | 98% |
| Care1St Hmo - Ehs | $18 | 98% |
| Cares Act Provider Relief Fund | $18 | 98% |
| Gemcare Hmo | $18 | 98% |
| Generic | $18 | 98% |
| Generic Bscphp | $18 | 98% |
| Generic Victims Of Crime | $18 | 98% |
| Hartford Life Supplement | $18 | 98% |
| Healthnet Hmo - Cvmp/Medpro | $18 | 98% |
| Healthnet Hmo - Dhmso | $18 | 98% |
| Healthnet Hmo - La Salle | $18 | 98% |
| Healthnet Hmo - Sante | $18 | 98% |
| Healthnet Sante | $18 | 98% |
| Healthnet Sante - Sub Cap Dual Risk | $18 | 98% |
| Healthnet Sante Dual Risk | $18 | 98% |
| Humana | $18 - $153 | 98% |
| Kaiser | $18 | 98% |
| Medi-Cal Innovative Integrated Health | $18 | 98% |
| Medicare (plans) | $18 | 98% |
| Meritage Blue Shield 65 Plus | $18 | 98% |
| Meritage Brand New Day | $18 | 98% |
| Meritage Healthnet Hmo | $18 | 98% |
| Railroad Part A | $18 | 98% |
| Railroad Part A & B | $18 | 98% |
| Railroad Part B | $18 | 98% |
| Sante | $18 - $25 | 98% |
| Sante Sub Cap Healthnet Seniority | $18 | 98% |
| Sante Sub Cap-Blue Shield/Sante | $18 | 98% |
| Sante-Blue Shield/Sante | $18 | 98% |
| Sante-Healthnet Seniority | $18 | 98% |
| Sante-Sub Cap Ma Brand New Day | $18 | 98% |
| Scan Health Plan | $18 | 98% |
| Sequoia Pace - Peak Tpa | $18 | 98% |
| Todays Pyramid | $18 | 98% |
| Us Marshal | $18 | 98% |
| Victims Of Crime | $18 | 98% |
| Wellcare | $18 | 98% |
| Generic Multiplan | $19 - $153 | 103% |
| Phcs | $19 - $153 | 103% |
| Alignment Health Plan | $20 | 109% |
| Champion Health Plan Of California Ma | $20 | 109% |
| Innovative Integrated Health Community Plans Hmo | $20 | 109% |
| Imperial Health Plan Hmo | $21 | 114% |
| Correctcare Integrated Health | $24 | 131% |
| Well Path (Cfmg) | $24 - $197 | 131% |
| Health Plan Of San Joaquin | $25 | 136% |
| Sequoia Pace | $25 | 136% |
| Adventist -Mcl Calviva Sub Cap | $27 | 147% |
| Coalinga State Hospital | $37 | 201% |
| Naphcare Inc-Mendota | $40 | 218% |