CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Saint Mary's Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $33
  • Cash Discount Price: $86
  • vs. Medicare Baseline: 1.79x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Saint Mary's Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.79x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$86

Average discount available for prompt cash payment at this facility.

Insurance Median
$33

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: $86 (468%)
Insurance Median: $33 (179%)
Cash: $86 (468% of Medicare)
Ins. Median: $33 (179% 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 $16 - $21 87%
Aetna $18 - $33 98%
Cca Senior Care Options $18 98%
Geha $18 98%
Harvard Pilgrim Healthcare $18 98%
Medicare (plans) $18 - $19 98%
UnitedHealthcare $18 - $156 98%
Cigna $19 - $125 103%
Connecticare $20 - $21 109%
Bcn Domestic $21 114%
Blue Benefit Administrators of Massachusetts $21 114%
Blue Care Network $21 114%
Blue Distinction Transplant $21 114%
Blue Shield - Ca $21 114%
Blue Shield - Id (Regence) $21 114%
Blue Shield - Ny Highmark Northeastern $21 114%
Blue Shield - Ny Highmark Western $21 114%
Blue Shield - PA (Highmark) $21 114%
Blue Shield - Wa (Regence) $21 114%
Health Choices $21 114%
Kaiser Domestic $21 114%
Pre-Employment $21 114%
Unicare $21 114%
Wc Domestic $21 114%
Wellpoint $21 114%
Centivo $23 125%
1199 National Benefit Fund $33 179%
Allied Benefit Systems $33 179%
Gravie Admin Services $33 179%
Hap $33 179%
Luminare Health $33 179%
Meritain $33 179%
Nippon Life Ins $33 179%
Webtpa $33 179%
Allegiance $37 201%
Health Partners $37 201%
Magnacare $37 201%
Claimdoc $39 212%
Connecticut Dept of Correction $39 212%
Diversified Administrators $39 212%
Innovative Health Plan II $39 212%
Carelon Behavioral Health $78 424%
Health New England $83 451%
Allied National Global Care $120 653%
Asrm - Reliance Standard Life Insurance $120 653%
Christian Care Ministry $120 653%
Dean Health $120 653%
Fallon Health $120 653%
Family Life Insurance Company $120 653%
Ghc Scw $120 653%
International Benefit Administrators $120 653%
Lifetime Benefit Solutions $120 653%
Manhattan Life $120 653%
Medi Share $120 653%
Multiplan $120 653%
Mvp $120 653%
PHCS $120 653%
Pai $120 653%
Pan-American Life $120 653%
Paramount HMO $120 653%
Trinity Health Share $120 653%
Prime Health Services $125 680%
Health Smart $133 723%
United Behavioral Health Eap $156 848%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals