CMS Price Transparency Data
Blood test, PSA (prostate screen)
Facility: Claiborne Memorial Medical Center
Billing Code: 84153 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 84153
- Insurance Median: $49
- Cash Discount Price: $76
- vs. Medicare Baseline: 2.66x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Claiborne Memorial Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 2.66x the Medicare baseline. Located in 620 East College Street, Homer, LA.
Cash / Self-Pay
$76
Average discount available for prompt cash payment at this facility.
Insurance Median
$49
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: $76 (413%)
Insurance Median: $49 (266%)
Cash: $76 (413% of Medicare)
Ins. Median: $49 (266% 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 266% of the Medicare baseline (a markup of 166%). 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 | $18 - $49 | 98% |
| Amerihealth Caritas La | $18 - $33 | 98% |
| Arcadian Community Mcr Hm | $18 | 98% |
| Blue Cross Blue Shield | $18 - $100 | 98% |
| Champus | $18 | 98% |
| Champva | $18 | 98% |
| Cigna | $18 - $57 | 98% |
| Community Health Solution | $18 - $33 | 98% |
| Correctcare Intergrated | $18 - $33 | 98% |
| Healthy Blue | $18 - $33 | 98% |
| Healthy Blue Dual Adv | $18 | 98% |
| Humana | $18 - $76 | 98% |
| Kaiser Foundation Health | $18 | 98% |
| Louisiana Hc Connections | $18 - $33 | 98% |
| Magellan Services | $18 - $33 | 98% |
| Medicaid / KanCare | $18 - $33 | 98% |
| Medicare (plans) | $18 | 98% |
| Peoples Health Network | $18 | 98% |
| Pyramid Claims Mcr Hmo | $18 | 98% |
| Sterling Connect 2 | $18 | 98% |
| Sterling Premier Mc Hmo | $18 | 98% |
| Superior Health Mcr Hmo | $18 | 98% |
| Tenet Mcr Hmo | $18 | 98% |
| Tricare | $18 | 98% |
| United Hc Mcr Hmo | $18 | 98% |
| UnitedHealthcare | $18 - $33 | 98% |
| Universal Hc Mcr Hmo | $18 | 98% |
| Us Dept Of Labor | $18 | 98% |
| Vantage Health Mcr Hmo | $18 | 98% |
| Windsor Sterling Mcr Hmo | $18 | 98% |
| Wps Mvh Vapc3 | $18 | 98% |
| All Savers | $23 | 125% |
| Golden Rule Ins Co | $23 | 125% |
| United Behavioral Health | $23 | 125% |
| Vantage Health Plan Inc | $24 | 131% |
| Ambetter / Centene | $26 | 141% |
| Commercial Insurance | $30 - $76 | 163% |
| Meritain Health | $30 - $49 | 163% |
| Coventry Healthcare | $45 | 245% |
| Geha | $53 | 288% |
| Health Plus Of La | $53 - $57 | 288% |
| Apwu Healthplan | $57 | 310% |
| Great West Healthcare | $57 | 310% |
| Phcs | $61 | 332% |
| Ppo Plus | $61 | 332% |
| Sedgwick Claims Mgmt Serv | $68 | 370% |
| Workman'S Comp | $68 | 370% |
| Aarp | $76 | 413% |
| Accordia National | $76 | 413% |
| Aflac | $76 | 413% |
| Alameda Alliance Forhealt | $76 | 413% |
| American Pioneer | $76 | 413% |
| Benefit Management | $76 | 413% |
| Benesys Inc | $76 | 413% |
| Business Guarantor | $76 | 413% |
| Chubb | $76 | 413% |
| Commercial Sr. Care | $76 | 413% |
| Employee Benefit Services | $76 | 413% |
| Family Life Insurance Co | $76 | 413% |
| Farm Bureau Insurance | $76 | 413% |
| Fiserv Health Benefit | $76 | 413% |
| Gmp | $76 | 413% |
| Group And Pension Admin | $76 | 413% |
| Group Resources | $76 | 413% |
| Haik Minvielle And Grubbs | $76 | 413% |
| Harrington Benefit Svs | $76 | 413% |
| Health Design Plus | $76 | 413% |
| Health Plan | $76 | 413% |
| Healthscope Benefits | $76 | 413% |
| Insurance Management Admi | $76 | 413% |
| Jefferson National | $76 | 413% |
| John Alden Health Ins | $76 | 413% |
| John Hancock | $76 | 413% |
| Liberty Mutual | $76 | 413% |
| Mailhandlers Benefit Plan | $76 | 413% |
| Manhattan Life Ins Co | $76 | 413% |
| Mega Life And Health | $76 | 413% |
| Msa Careguard | $76 | 413% |
| Mutual Of Omaha | $76 | 413% |
| Nalc Health Benefit Plan | $76 | 413% |
| Naphcare Inc. | $76 | 413% |
| New Era Life Ins Co | $76 | 413% |
| Physicians Mutual | $76 | 413% |
| Principal Financial Group | $76 | 413% |
| Prudential Healthcare | $76 | 413% |
| Self Pay | $76 | 413% |
| State Farm | $76 | 413% |
| State Farm Insurance | $76 | 413% |
| State Mutual Insurance Co | $76 | 413% |
| Sterling Investors Life | $76 | 413% |
| Tower Life | $76 | 413% |
| Transamerica Premier Ins | $76 | 413% |
| United American | $76 | 413% |
| United Comm Travelers | $76 | 413% |
| United Teachers | $76 | 413% |
| Usable Administrator | $76 | 413% |
| Visn 16 Cfu | $76 | 413% |
| Wausau Benefits | $76 | 413% |
| Webtpa | $76 | 413% |
| Wells Fargo | $76 | 413% |
| Woodmen Of The World | $76 | 413% |