CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Jacksonville Memorial Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $225
Cash Discount Price: $375
vs. Medicare Baseline: 12.23x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Jacksonville Memorial Hospital is $225. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $375. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 12.23x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$375

Average discount available for prompt cash payment at this facility.

Insurance Median

$225

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: $375 (2039%)

Insurance Median: $225 (1223%)

Cash: $375 (2039% of Medicare)

Ins. Median: $225 (1223% 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 1223% of the Medicare baseline (a markup of 1123%). 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	$17 - $375	92%
Coventry	$18 - $59	98%
Health Alliance	$18 - $255	98%
Humana	$18 - $320	98%
Medicare (plans)	$18 - $59	98%
Tricare	$18	98%
Medicaid / KanCare	$19	103%
Molina Healthcare	$19	103%
UnitedHealthcare	$19 - $270	103%
Corvel/Corcare	$76 - $84	413%
Illinois Workers Compensation	$82 - $122	446%
Commercial Workers Compensation	$116	631%
Health Alliance Mh Employee Plan	$172	935%
Current Health Network	$206 - $281	1120%
6 Degrees Health	$225	1223%
Hope Trust	$225	1223%
Hst	$225	1223%
Cigna	$260	1414%
Aetna	$262 - $300	1425%
Healthlink	$319	1735%
Phcs/Multiplan	$338	1838%
Hfn	$356	1936%
Liability	$375	2039%

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 $375.
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 Jacksonville Memorial 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.