CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Modoc Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $131
Cash Discount Price: $151
vs. Medicare Baseline: 7.12x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Modoc Medical Center is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 7.12x the Medicare baseline. Located in 1111 N Nagle Street, Alturas, CA.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $151 (821%)

Insurance Median: $131 (712%)

Cash: $151 (821% of Medicare)

Ins. Median: $131 (712% 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 712% of the Medicare baseline (a markup of 612%). 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
Multiplan Wc	$17	92%
Integrated Hp Wc	$18	98%
Ntwrks By Design Wc - All Plans	$18	98%
Adv Med Mgmt - All Plans	$21	114%
Medi-Cal	$21	114%
Medi-Cal 7/1/24	$21	114%
Partnership Hp - All Plans	$21	114%
Blue Shield Mcr Adv	$82	446%
Blue Shield Va	$82	446%
UnitedHealthcare	$82 - $144	446%
Tricare	$86	468%
Healthnet Mcr Adv	$87	473%
Blue Cross Blue Shield	$124 - $138	674%
Blue Shield Exch	$124	674%
Blue Shield Comm - All Other Plans	$138	750%
Carelon - All Plans	$138	750%
Corvel - All Plans	$142	772%
Aetna	$144	783%
Coventry/First Health - All Plans	$144	783%
Galaxy Health - All Plans	$144	783%
Healthnet Comm - All Other Plans	$144	783%
Hmn - All Plans	$144	783%
Integrated Hp - All Other Plans	$144	783%
Interplan - All Plans	$144	783%
Multiplan - All Other Plans	$144	783%
Superior Ca Ppo - All Plans	$144	783%

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 $151.
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 Modoc Medical Center 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.