CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Clarinda Regional Health Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $95
  • Cash Discount Price: $104
  • vs. Medicare Baseline: 5.17x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Clarinda Regional Health Center is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 5.17x the Medicare baseline. Located in 220 Essie Davison Drive, Clarinda, IA.
Cash / Self-Pay
$104

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

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: $104 (566%)
Insurance Median: $95 (517%)
Cash: $104 (566% of Medicare)
Ins. Median: $95 (517% 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 517% of the Medicare baseline (a markup of 417%). 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
Ambetter / Centene $43 - $105 234%
Molina Mcr Adv-All Plans $43 - $97 234%
UnitedHealthcare $43 - $192 234%
Blue Cross Blue Shield $44 - $161 239%
Ia Total Care Mcaid-All Plans $47 - $106 256%
Geha-All Plans $83 - $187 451%
Coventry Health-All Other Plans $84 - $190 457%
Midlands Choice-All Plans $85 - $192 462%
Multiplan-All Plans $85 - $192 462%
Amerigroup Ia Mcaid-All Plans $89 - $202 484%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 220 Essie Davison Drive, Clarinda, IA 51632
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals