CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Adventist Health Tulare

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $23
Cash Discount Price: $52
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Adventist Health Tulare is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.25x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.

Cash / Self-Pay

$52

Average discount available for prompt cash payment at this facility.

Insurance Median

$23

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: $52 (283%)

Insurance Median: $23 (125%)

Cash: $52 (283% of Medicare)

Ins. Median: $23 (125% 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
Blue Shield Epn	$3 - $118	16%
Blue Shield-All Other Plans	$4 - $163	22%
Cigna	$5 - $173	27%
Western Growers - All Plans	$5 - $172	27%
Blue Cross Blue Shield	$6 - $188	33%
Hs Interplan-All Plans	$7 - $251	38%
Network By Design-All Plans	$7 - $243	38%
UnitedHealthcare	$7 - $271	38%
Multiplan - All Plans	$9 - $318	49%
Ccipa Medi-Cal - All Plans	$10 - $27	54%
Dignity Mcal Op Only	$10 - $23	54%
Healthnet Medi-Cal	$10 - $28	54%
Independence Op Only - All Plans	$10 - $23	54%
Medi-Cal	$10 - $21	54%
Blue Shield Mcare	$18	98%
Dignity Mcr Op Only - All Other Plans	$18	98%
Fhcn Pace Mcr Adv - All Plans	$18	98%
Medicare (plans)	$18	98%
Prime Health - All Plans	$18	98%
Tricare	$18	98%
Cal Forensic Med Grp - All Plans	$24	131%
Prison Hlthcre - All Plans	$24	131%
Bright Health - All Plans	$27	147%
Ah Employee Health Plan - All Plans	$33	179%
Incentive Hlth - All Plans	$33	179%
Healthnet Hmo/Ppo - All Other Plans	$49	266%
Aetna	$159	865%

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 $52.
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 Tulare 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.