CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Northwestern Medicine Central Dupage Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $100
Cash Discount Price: $177
vs. Medicare Baseline: 5.44x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Northwestern Medicine Central Dupage Hospital is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $177. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 5.44x the Medicare baseline. Located in 25 North Winfield Road, Winfield, IL.

Cash / Self-Pay

$177

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $177 (962%)

Insurance Median: $100 (544%)

Cash: $177 (962% of Medicare)

Ins. Median: $100 (544% 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 544% of the Medicare baseline (a markup of 444%). 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
Blue Cross Blue Shield	$6 - $363	33%
Countycare Il Cook Co [1607]	$6 - $25	33%
Medicaid / KanCare	$6 - $25	33%
Aetna	$13 - $127	71%
Carelon Behavioral Health [159]	$45 - $182	245%
Health'S Finest Network [126]	$45 - $331	245%
Multiplan/Phcs [142]	$52 - $363	283%
Dreyer Med Ipa Advocate [1409]	$54 - $218	294%
Humana	$54 - $363	294%
Magellan Behavioral Hlth [136]	$54 - $218	294%
Healthlink [125]	$57 - $229	310%
Choicecare [177]	$69 - $278	375%
First Health Plan [6034]	$69 - $279	375%
Cigna	$72 - $290	392%
Compsych [112]	$72 - $290	392%
UnitedHealthcare	$90 - $363	489%

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 $177.
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 Northwestern Medicine Central Dupage 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.