CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Seneca District Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $26
Cash Discount Price: $22
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Seneca District Hospital is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.41x the Medicare baseline. Located in 130 Brentwood Drive, Chester, CA.

Cash / Self-Pay

$22

Average discount available for prompt cash payment at this facility.

Insurance Median

$26

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: $22 (120%)

Insurance Median: $26 (141%)

Cash: $22 (120% of Medicare)

Ins. Median: $26 (141% 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
Tricare	$3 - $149	16%
UnitedHealthcare	$3 - $209	16%
Blue Cross Blue Shield	$4 - $192	22%
Blue Shield Ipf/Ca Exchange	$4 - $190	22%
Imperial Hp Ma-All Plans	$4 - $168	22%
Alliance- All Plans	$5 - $207	27%
Ambetter / Centene	$5 - $26	27%
Amthem Bc Mcal	$5 - $21	27%
Beech Street Corp- All Plans	$5 - $202	27%
Blue Shield Of Ca- All Other Plans	$5 - $211	27%
Cigna	$5 - $202	27%
Community Care Network - All Plans	$5 - $207	27%
Coventry- All Plans	$5 - $209	27%
Healthnet - All Other Plans	$5 - $211	27%
Integrated Hp-All Plans	$5 - $202	27%
Interplan Corp- All Plans	$5 - $202	27%
Medi-Cal	$5 - $21	27%
Medincrease- All Plans	$5 - $202	27%
Multiplan- All Plans	$5 - $202	27%
Northern Nevada Health Network- All Plans	$5 - $209	27%
Pacificare - All Plans	$5 - $202	27%
Partnership Hp-All Plans	$5 - $21	27%
Provider Ntwrk Of America-All Plans	$5 - $202	27%
Superior California Ppo - All Plans	$5 - $209	27%
Three Rivers- All Plans	$5 - $211	27%

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 $22.
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 Seneca District 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.