CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Rochelle Community Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $191
Cash Discount Price: $254
vs. Medicare Baseline: 10.39x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Rochelle Community Hospital is $191. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 10.39x the Medicare baseline. Located in 900 N 2Nd St, Rochelle, IL.

Cash / Self-Pay

$254

Average discount available for prompt cash payment at this facility.

Insurance Median

$191

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: $254 (1381%)

Insurance Median: $191 (1039%)

Cash: $254 (1381% of Medicare)

Ins. Median: $191 (1039% 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 1039% of the Medicare baseline (a markup of 939%). 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	$17 - $89	92%
Blue Cross Blue Shield	$17 - $254	92%
Medicaid / KanCare	$17	92%
The Alliance-All Plans	$47	256%
Health Alliance Mcr Adv	$89	484%
Humana	$89 - $203	484%
UnitedHealthcare	$89 - $229	484%
Va Ccn - All Plans	$89	484%
Wellcare Mcr Adv - All Plans	$91	495%
Cigna	$190	1033%
Osf Dan Ppo - All Plans	$190	1033%
Beech Street-All Plans	$203	1104%
First Health - All Plans	$203	1104%
Health Alliance-All Other Plans	$203	1104%
Ecoh-All Plans	$216	1175%
Hfn-All Plans	$216	1175%
Quartz Health Solutions-All Plans	$224	1218%
Multiplan-All Plans	$239	1300%

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 $254.
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 Rochelle Community 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.