CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Rush Memorial Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $65
Cash Discount Price: $102
vs. Medicare Baseline: 3.53x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Rush Memorial Hospital is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 3.53x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$102

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: $102 (555%)

Insurance Median: $65 (353%)

Cash: $102 (555% 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.

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
Health Net	$18 - $61	98%
Aetna	$19 - $192	103%
Caresource Mcr Adv	$19 - $65	103%
Humana	$19 - $192	103%
My True Advantage - All Plans	$19 - $65	103%
UnitedHealthcare	$19 - $167	103%
Blue Cross Blue Shield	$20 - $153	109%
Today'S Option Mcr Adv-All Plans	$20 - $67	109%
Viant Beech St Mcr Adv	$20 - $67	109%
Caresource Marketplace-All Other Plans	$31 - $104	169%
Cigna	$49 - $167	266%
Phcs-All Plans	$49 - $167	266%
Consumers Life Ins-All Plans	$56 - $188	305%
Coventry/First Health-All Plans	$56 - $188	305%
Multiplan-All Plans	$57 - $194	310%
Sagamore-All Plans	$57 - $192	310%
Siho-All Plans	$57 - $192	310%
Community Health Alliance-All Plans	$58 - $196	315%
Encore Health Services-All Plans	$61 - $205	332%

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 $102.
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 Rush 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.