CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Dallas County Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $86
Cash Discount Price: $112
vs. Medicare Baseline: 4.68x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Dallas County Hospital is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 4.68x the Medicare baseline. Located in 610 Tenth Street, Perry, IA.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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: $112 (609%)

Insurance Median: $86 (468%)

Cash: $112 (609% of Medicare)

Ins. Median: $86 (468% 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 468% of the Medicare baseline (a markup of 368%). 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
Medicare (plans)	$18 - $79	98%
Aetna	$76 - $79	413%
Humana	$76 - $79	413%
UnitedHealthcare	$77 - $149	419%
Amerigroup Wellpoint	$86 - $89	468%
Iowa Total Care Mcd Adv (Active 7/1/19)	$86 - $89	468%
Medicaid / KanCare	$86 - $89	468%
Molina Healthcare Of Iowa Mcd Rep	$86 - $89	468%

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 $112.
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 Dallas County 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.