CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: HCA Florida Twin Cities Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $37
  • Cash Discount Price: $243
  • vs. Medicare Baseline: 2.01x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at HCA Florida Twin Cities Hospital is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $243. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 2.01x the Medicare baseline. Located in 2190 Hwy 85 N, Niceville, FL.
Cash / Self-Pay
$243

Average discount available for prompt cash payment at this facility.

Insurance Median
$37

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: $243 (1321%)
Insurance Median: $37 (201%)
Cash: $243 (1321% of Medicare)
Ins. Median: $37 (201% 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 201% of the Medicare baseline (a markup of 101%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Avmed $2 - $388 11%
Sunshine State Health Plan $2 - $198 11%
United $2 - $349 11%
Aetna $3 - $232 16%
Humana $3 - $294 16%
Molina Healthcare $3 - $248 16%
Plotkin Health $4 - $388 22%
Prime Health Sheriff $4 - $388 22%
Evolutions Healthcare $6 - $659 33%
Multiplan $7 - $659 38%
Ppo Next $7 - $659 38%
Novanet $8 - $698 44%
Ndms Definitive Care $18 98%
Regency Hospice $18 98%
Wellmed $18 98%
American Health Plan $19 103%
Blue Cross Blue Shield $19 103%
Sunshine State $19 103%
Wellcare $19 103%
Centurion $20 109%
Clear Spring Health $20 109%
Florida Complete Care $20 109%
Gold Kidney Of Florida $20 109%
Healthspring Of Florida $20 109%
Ultimate Health Plan $21 114%
Longevity Health Plan $22 120%
Oscar $25 136%
Simply Healthcare $29 158%
Simply $37 - $119 201%
Corvel Corporation $150 816%
Prime Health $154 837%
Careworks (Rockport Community) $158 859%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2190 Hwy 85 N, Niceville, FL 32578
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals