CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Adventist Health Twin Cities

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $18
Cash Discount Price: $1
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Adventist Health Twin Cities is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 0.98x the Medicare baseline. Located in 1100 Las Tablas Rd, Templeton, CA.

Cash / Self-Pay

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: $1 (5%)

Insurance Median: $18 (98%)

Cash: $1 (5% 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
Cencal Mcal	$4 - $17	22%
Blue Shield Epn	$5 - $204	27%
Hpn-Heritage Prov Ntwrk-All Plans	$5	27%
UnitedHealthcare	$5 - $190	27%
Blue Shield Hmo/Pos	$6 - $100	33%
Blue Shield Epo/Ppo - All Other Plans	$7 - $117	38%
Chn-Community Hlth Ntwrk-All Plans	$8 - $311	44%
Nbd-Ntwrks By Design Exlus-All Other Plans	$9 - $327	49%
Nbd-Ntwrks By Design Non-Exlus	$9 - $327	49%
Pacific Health Alliance-All Plans	$14 - $509	76%
Medi-Cal	$15 - $241	82%
Aetna	$18	98%
Blue Shield Promise Mcal	$18 - $680	98%
Cencal Mcr Adv - All Other Plans	$18	98%
Tricare	$18	98%
Ccah-Centrl Ca Allince Mcal-All Plans	$20 - $313	109%
Coalinga-All Plans	$20 - $736	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

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1.
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 Adventist Health Twin Cities 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.