CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Adventist Health Clearlake

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $19
  • Cash Discount Price: $47
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Adventist Health Clearlake is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.03x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.
Cash / Self-Pay
$47

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

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: $47 (256%)
Insurance Median: $19 (103%)
Cash: $47 (256% of Medicare)
Ins. Median: $19 (103% 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 Cross Blue Shield $2 - $215 11%
Blue Shield Mcr Adv $2 - $84 11%
Kaiser Mcr Adv $2 - $84 11%
Tricare $2 - $84 11%
UnitedHealthcare $2 - $332 11%
Ah Employee Health Plan - All Plans $4 - $167 22%
Aetna $8 - $297 44%
Blue Shield Epn - All Other Plans $8 - $306 44%
Blue Shield Non-Epn $8 - $306 44%
First Health- All Plans $8 - $318 44%
Healthnet- All Plans $8 - $326 44%
Western Growers- All Plans $8 - $298 44%
Cigna $9 - $358 49%
Foundation- All Plans $9 - $338 49%
Health Mgmt Network- All Plans $9 - $338 49%
Humana $9 - $338 49%
Interplan- All Plans $9 - $358 49%
Kaiser- All Other Plans $9 - $358 49%
Phcs- All Plans $9 - $338 49%
Three Rivers Provider Network- All Plans $9 - $358 49%
Bc Managed Mcal $10 - $21 54%
Medi-Cal $10 - $21 54%
Partnership Mcal - All Plans $10 - $21 54%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15630 18Th Ave - Hwy 53, Clearlake, CA 95422
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals