CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Monroe Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $27
Cash Discount Price: $18
vs. Medicare Baseline: 1.47x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Monroe Hospital is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.47x the Medicare baseline. Located in 4011 S Monroe Medical Park Blvd, Bloomington, IN.

Cash / Self-Pay

$18

Average discount available for prompt cash payment at this facility.

Insurance Median

$27

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: $18 (98%)

Insurance Median: $27 (147%)

Cash: $18 (98% of Medicare)

Ins. Median: $27 (147% 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.

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	$18	98%
Blue Cross Blue Shield	$18 - $33	98%
Care Source	$18 - $27	98%
Medicaid / KanCare	$18	98%
Medicare (plans)	$18	98%
Monroe Medical Group And Managed Health Services	$18 - $25	98%
Tricare	$18	98%
UnitedHealthcare	$18	98%
Usa Senior Care Network	$18	98%
Worthington Christian Fellowship	$18	98%
Provider Partners Health Plan	$20	109%
Employer Direct Healthcare	$26	141%
Americas Choice Provider Network Acpn	$32 - $36	174%
Corvel Workers Compensation	$32	174%
Encore Health Network Workers Compensation	$32 - $36	174%
Multiplan	$32 - $36	174%
Prime Health Services	$32 - $36	174%
Provider Network Of America	$32 - $37	174%
Provider Select	$32 - $36	174%
Three Rivers	$32 - $36	174%
Workers Compensation	$32 - $37	174%
Zelis Healthcare Fka Stratose	$32 - $35	174%

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 $18.
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 Monroe 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.