CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Memorial Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $193
Cash Discount Price: $321
vs. Medicare Baseline: 10.49x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Memorial Medical Center is $193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $321. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 10.49x the Medicare baseline. Located in 701 N First St, Springfield, IL.

Cash / Self-Pay

$321

Average discount available for prompt cash payment at this facility.

Insurance Median

$193

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: $321 (1746%)

Insurance Median: $193 (1049%)

Cash: $321 (1746% of Medicare)

Ins. Median: $193 (1049% 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 1049% of the Medicare baseline (a markup of 949%). 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
Health Alliance	$8 - $209	44%
Medicaid / KanCare	$12	65%
Molina	$12	65%
Veterans Administration	$13	71%
Blue Cross Blue Shield	$17 - $321	92%
Aetna	$18 - $244	98%
Medicare (plans)	$18 - $321	98%
Tricare	$18	98%
UnitedHealthcare	$18 - $199	98%
Humana	$19 - $193	103%
Healthlink	$64 - $202	348%
Commercial Workers Compensation	$93	506%
Illinois Workers Compensation	$98	533%
Current Health Network Ppo	$144	783%
Cigna	$169	919%
Phcs/Multiplan	$173 - $193	941%
6 Degrees Health	$193	1049%
Hopetrust	$193	1049%
Hst	$193	1049%
Magellan	$193	1049%
Consociate	$209	1136%
Hfn	$209	1136%
Preferred Plan	$241	1310%
Soi Mcfarland	$241	1310%
Soi Rushville	$241	1310%
Corvel	$257	1397%
Methodist First Choice	$257	1397%
Mutual Medical Plans	$273	1485%
Liability	$321	1746%

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 $321.
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 Memorial Medical Center 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.