CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Franklin General Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $74
Cash Discount Price: $158
vs. Medicare Baseline: 4.02x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Franklin General Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 4.02x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$158

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

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: $158 (859%)

Insurance Median: $74 (402%)

Cash: $158 (859% of Medicare)

Ins. Median: $74 (402% 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 402% of the Medicare baseline (a markup of 302%). 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
UnitedHealthcare	$32 - $146	174%
Wellmark Hmo	$46	250%
Wellmark Ppo - All Other Plans	$50	272%
Medical Associates Mcare	$70	381%
Mount Carmel Hp-All Plans	$70	381%
Tricare	$70	381%
Amerigroup Mcare	$71	386%
Wellmark Mcr Adv	$71	386%
Molina Mcare	$73	397%
Ambetter / Centene	$74 - $113	402%
American Hp Iowa - All Plans	$74	402%
Amerigroup Mcaid - All Other Plans	$74	402%
Molina Mcaid - All Other Plans	$75	408%
Centivo - All Plans	$106	576%
Medical Ass Hosp Employer Group	$106	576%
Oscar - All Plans	$106	576%
Midlands Choice-All Plans	$123	669%
Medical Associates Hp-All Other Plans	$150	816%
Preferred Health Choices-All Plans	$150	816%
Splashlight Llc-All Plans	$150	816%
Aetna	$164 - $167	892%
Multiplan-All Plans	$167	908%

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 $158.
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 Franklin General 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.