CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Norton-King's Daughters' Health

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $107
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 5.82x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Norton-King's Daughters' Health is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 5.82x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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: $36 (196%)
Insurance Median: $107 (582%)
Cash: $36 (196% of Medicare)
Ins. Median: $107 (582% 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 582% of the Medicare baseline (a markup of 482%). 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 $14 - $185 76%
Blue Cross Blue Shield $18 - $57 98%
Humana $18 98%
Managed Health Services Of Indiana $18 98%
Managed Health Services Of Kentucky $18 98%
Passport By Molina $18 98%
UnitedHealthcare $18 - $165 98%
Managed Health Services $19 - $28 103%
Caresource Of Kentucky $26 141%
Caresource Of Indiana $28 152%
Custom Design Benefits $37 - $105 201%
Cigna $101 - $178 549%
Encore $101 - $178 549%
Quality Care Partners $106 - $187 576%
Bluegrass $107 - $189 582%
First Health $107 - $189 582%
Healthlink $107 - $189 582%
Vha/Tristate $107 - $189 582%
Multiplan/Phcs $109 - $193 593%
Indiana Health Network $113 - $200 614%
Siho $113 - $200 614%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1373 East Sr 62, Madison, IN 47250
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals