CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Woodlawn Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $61
Cash Discount Price: $209
vs. Medicare Baseline: 3.32x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Woodlawn Hospital is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $209. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 3.32x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$209

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

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: $209 (1136%)

Insurance Median: $61 (332%)

Cash: $209 (1136% of Medicare)

Ins. Median: $61 (332% 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 332% of the Medicare baseline (a markup of 232%). 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	$10 - $212	54%
Caresource Mcaid Hww	$18	98%
Mdwise Excel Hhw & Hcc	$18	98%
Mhs Mcaid Hcc	$18	98%
Mhs Mcaid Hhw	$18	98%
UnitedHealthcare	$18 - $212	98%
Partners Direct Health-All Plans	$51	277%
Aetna	$61 - $265	332%
Caresource Mcaid Hip	$61	332%
Caresource Mcr Adv	$61	332%
Humana	$61 - $216	332%
Mdwise Mcaid Excel Hip	$61	332%
Mhs Exch Mrktplce-All Other Plans	$61	332%
Mhs Mcaid Hip	$61	332%
Mhs Mcr Adv	$63	343%
Caresource Exch - All Other Plans	$80	435%
Ambetter / Centene	$82	446%
Cigna	$200 - $237	1088%
Parkview Health Plans-All Plans	$209	1136%
Sagamore All Other Grps - All Other Plans	$234	1272%
Encore Comm-All Plans	$237	1289%
Phcs/Multiplan-All Plans	$259	1408%
Community Health Alliance-All Plans	$265	1441%

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 $209.
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 Woodlawn 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.