CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: UW Health

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $37
Cash Discount Price: $50
vs. Medicare Baseline: 2.01x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at UW Health is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 2.01x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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: $50 (272%)

Insurance Median: $37 (201%)

Cash: $50 (272% of Medicare)

Ins. Median: $37 (201% 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 201% of the Medicare baseline (a markup of 101%). 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
Aetna	$18 - $144	98%
Blue Cross Blue Shield	$18 - $99	98%
Humana	$18	98%
Medicare (plans)	$18 - $20	98%
Mychoice Wi Medical Adv	$18	98%
UnitedHealthcare	$18 - $29	98%
Quartz Fully Insured	$23 - $24	125%
Quartz Aso	$26 - $27	141%
Ecoh	$37 - $157	201%
Hfn	$37 - $157	201%
Alliance Premier Network	$109	593%
The Alliance	$140	761%
Wps Ppo	$155	843%
Cigna	$160	870%
Beloit Healt System	$180	979%
Mercycare	$187	1017%
First Health/Coventry	$197	1071%
Health Payment Systems	$233	1267%
Healthsmart	$233	1267%
Sheboygan Employers Health Network	$249	1354%
Multiplan	$278	1512%

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 $50.
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 UW Health 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.