CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Sullivan County Community Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $55
Cash Discount Price: $108
vs. Medicare Baseline: 2.99x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Sullivan County Community Hospital is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 2.99x the Medicare baseline. Located in 2200 N Section St, Sullivan, IN.

Cash / Self-Pay

$108

Average discount available for prompt cash payment at this facility.

Insurance Median

$55

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: $108 (587%)

Insurance Median: $55 (299%)

Cash: $108 (587% of Medicare)

Ins. Median: $55 (299% 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 299% of the Medicare baseline (a markup of 199%). 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
Humana	$18 - $156	98%
Mdwise Mcaid - All Other Plans	$18	98%
Mhs Hlthy In Mcaid	$18	98%
Mhs Mcaid - All Other Plans	$18	98%
Va Ccn - All Plans	$19 - $34	103%
Ambetter / Centene	$32 - $55	174%
Blue Cross Blue Shield	$32 - $97	174%
Mdwise Mcr Adv	$32 - $55	174%
Siho - All Plans	$79 - $138	430%
UnitedHealthcare	$89 - $156	484%

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 $108.
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 Sullivan County Community 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.