CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Saint Joseph Regional Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $65
  • Cash Discount Price: $161
  • vs. Medicare Baseline: 3.53x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Saint Joseph Regional Medical Center is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $161. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 3.53x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$161

Average discount available for prompt cash payment at this facility.

Insurance Median
$65

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: $161 (875%)
Insurance Median: $65 (353%)
Cash: $161 (875% of Medicare)
Ins. Median: $65 (353% 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 353% of the Medicare baseline (a markup of 253%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $10 - $121 54%
Blue Cross Blue Shield $10 - $37 54%
Medicaid / KanCare $10 - $18 54%
UnitedHealthcare $10 - $157 54%
Managed Health Services - Indiana $18 98%
Mdwise $18 98%
Medicare (plans) $18 - $19 98%
Meridian Complete $18 98%
Pace-Trinity Health $18 98%
County Coroner $19 103%
Provider Partners Health Plan Of Indiana $20 109%
Auxiant $28 - $205 152%
Caresource $28 152%
Physicians Health Plan Northern Indiana Health Insurance $28 - $56 152%
St Joseph County Hlth Dpt $28 152%
Siho Insurance Services $29 158%
Key Benefit Administrator $33 - $154 179%
Allied Benefit Systems $35 - $161 190%
Blue Benefit Administrators Of Massachusetts $37 201%
Blue Care Network $37 201%
Blue Distinction Transplant $37 201%
Blue Shield - Ca $37 201%
Blue Shield - Id (Regence) $37 201%
Blue Shield - Ny Highmark Northeastern $37 201%
Blue Shield - Ny Highmark Western $37 201%
Blue Shield - Pa (Highmark) $37 201%
Blue Shield - Wa (Regence) $37 201%
Custom Design Benefits $40 218%
Hospice Of Marshall County $64 348%
Hospice Of St Joseph County $64 348%
Plain Church Group $67 364%
Asr Health Benefits $121 658%
Christian Brother Services $121 658%
Employee Benefit Management $121 658%
Medical Mutual $121 658%
Meritain $121 658%
Preferred One $121 658%
Rural Carrier Health Benefit Plan $121 658%
Webtpa $121 658%
Notre Dame Athletic Association $136 740%
Wc Notre Dame $136 740%
Luminare Health (Detroit) $141 - $148 767%
Encore Health $146 - $154 794%
Ameriben $148 805%
Indiana Criminal Justice Inst $154 837%
Western & Southern Financial Group $154 837%
Geha $157 854%
Healthscope $157 854%
Student Insurance Cma $157 854%
Cigna $158 859%
Group Administrators $158 859%
Health Partners $158 859%
Mvp $158 859%
Prairie States $158 859%
Priority Health $158 859%
Professional Benefit Administrators $158 859%
Sagamore Health Network $158 - $183 859%
Sisco Benefits $158 859%
Unified Group Services $158 859%
Goshen Preferred Network $190 - $212 1033%
Christian Brothers Holy Cross $198 1077%
Signature Care $198 1077%
Bankers Life Casualty $247 1343%
Bureau Of Disability $247 1343%
Wc Align Network $247 1343%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals