CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Adventist Health Sierra Vista

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $12
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 0.65x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Adventist Health Sierra Vista is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 0.65x the Medicare baseline. Located in 1010 Murray St, San Luis Obispo, CA.
Cash / Self-Pay
$49

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $49 (266%)
Insurance Median: $12 (65%)
Cash: $49 (266% of Medicare)
Ins. Median: $12 (65% 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
Blue Shield Epo/Ppo-All Other Plans $2 - $8 11%
Nbd-Ntwrks By Design Non-Exclus $2 - $9 11%
Blue Shield Promise Mcal $4 - $18 22%
Cencal Mcal $4 - $17 22%
Hpn-Heritage Prov Ntwrk-All Plans $5 27%
UnitedHealthcare $5 - $18 27%
Blue Shield Epn $6 - $424 33%
Blue Shield Hmo/Pos $7 - $27 38%
Nbd-Ntwrks By Design Exclus-All Other Plans $9 - $78 49%
Medi-Cal $15 - $135 82%
Aetna $18 98%
Cencal Mcr Adv - All Other Plans $18 98%
Tricare $18 98%
Ccah-Centrl Ca Allince Mcal-All Plans $20 - $73 109%
Coalinga-All Plans $20 - $1,407 109%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans $24 131%
Ah Employee Health Plan - All Plans $33 179%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1010 Murray St, San Luis Obispo, CA 93405
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals