CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Loma Linda University Children's Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $49
Cash Discount Price: $90
vs. Medicare Baseline: 2.66x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Loma Linda University Children's Hospital is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 2.66x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$49

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: $90 (489%)

Insurance Median: $49 (266%)

Cash: $90 (489% of Medicare)

Ins. Median: $49 (266% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 266% of the Medicare baseline (a markup of 166%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Adventist Health	$3 - $54	16%
Lluh Dept Of Risk Management	$3 - $65	16%
Epic Health Plan	$5 - $108	27%
Kaiser Foundation Hospitals	$5 - $180	27%
Blue Shield Of California	$6 - $83	33%
Cigna	$8 - $91	44%
Global Benefits Group	$8 - $162	44%
Temecula Valley Physicians Medical Group	$8 - $74	44%
Trivalley Medical Group	$8 - $74	44%
Aetna	$9 - $81	49%
Networks By Design	$9 - $176	49%
Galaxy Health	$11 - $230	60%
Multiplan	$11 - $216	60%
Prime Health Services	$11 - $230	60%
UnitedHealthcare	$15	82%
Alpha Care Medical Group	$18 - $28	98%
Dignity Health	$18 - $28	98%
Inland Empire Health Plan (Iehp)	$18 - $27	98%
Upland Medical Group	$18	98%
Vantage Medical Group	$18 - $28	98%
Molina Healthcare Of Ca	$23 - $25	125%
Heritage Provider Network	$30	163%
Blue Cross Blue Shield	$182	990%

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 $90.
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 Loma Linda University Children's Hospital 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.