CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Lutheran Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $146
Cash Discount Price: Unavailable
vs. Medicare Baseline: 7.94x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Lutheran Medical Center is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 7.94x the Medicare baseline. Located in 8300 W 38Th Ave, Wheat Ridge, CO.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

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%)

Insurance Median: $146 (794%)

Ins. Median: $146 (794% 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 794% of the Medicare baseline (a markup of 694%). 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
Cigna	$12 - $482	65%
Aarp	$18	98%
Geha	$18 - $280	98%
Kaiser Snp	$18	98%
Select Health	$18	98%
UnitedHealthcare	$18 - $280	98%
Blue Cross Blue Shield	$33 - $405	179%
Kaiser Perm Hmo	$43 - $203	234%
Denv Hlth Med Plan	$48	261%
Kaiser Self Funded	$53 - $203	288%
Kaiser Perm Ppo/Pos	$54 - $209	294%
Allegiance	$58 - $120	315%
Aetna	$86 - $432	468%
Preferred One	$92 - $192	500%
Humana	$97 - $202	527%
Cofinity	$166 - $347	903%
First Health Network	$166 - $347	903%
Private Hlthcare Sys	$173 - $362	941%
Multiplan Inc	$194 - $405	1055%

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 $X.
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 Lutheran 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.