CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Sarasota Memorial Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $19
Cash Discount Price: $52
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Sarasota Memorial Hospital is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.03x the Medicare baseline. Located in 1700 S Tamiami Trl, Sarasota, FL.

Cash / Self-Pay

$52

Average discount available for prompt cash payment at this facility.

Insurance Median

$19

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: $52 (283%)

Insurance Median: $19 (103%)

Cash: $52 (283% of Medicare)

Ins. Median: $19 (103% 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
Amerihealth Caritas Oncology	$3 - $11	16%
Community Care Plan Oncology	$3 - $11	16%
Florida Community Care Oncology	$3 - $22	16%
Molina Oncology	$3 - $11	16%
Simply Healthcare Oncology	$3 - $11	16%
Sunshine State Oncology	$3 - $11	16%
Simply Healthcare	$6	33%
Sunshine State	$6	33%
Amerihealth Caritas	$7	38%
Community Care Plan	$7	38%
Florida Community Care	$7 - $20	38%
Molina	$7	38%
UnitedHealthcare	$10 - $131	54%
Aetna	$11 - $165	60%
Avmed	$12 - $127	65%
First Health	$13 - $144	71%
Usa Managed Care	$13 - $139	71%
Blue Cross Blue Shield	$18 - $32	98%
Simply Freedom Optimum	$19	103%
Simply Freedom Optimum Oncology	$19	103%
Wellcare	$19	103%
Wellcare Oncology	$19	103%
Oscar Oncology	$30	163%
Ambetter / Centene	$50	272%
Careworks	$76 - $165	413%
Enlyte	$76 - $165	413%

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 $52.
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 Sarasota Memorial 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.