CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Southcoast Hospitals Group

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $22
Cash Discount Price: $59
vs. Medicare Baseline: 1.20x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Southcoast Hospitals Group is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.20x the Medicare baseline. Located in 363 Highland Avenue, Fall River, MA.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$22

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: $59 (321%)

Insurance Median: $22 (120%)

Cash: $59 (321% of Medicare)

Ins. Median: $22 (120% 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 - $89	98%
Blue Cross Blue Shield	$18 - $37	98%
Evercare [1010304]	$18	98%
Medicare (plans)	$18 - $29	98%
Tufts Senior Care Options [1010315]	$18	98%
UnitedHealthcare	$18 - $22	98%
Commonwealth Care Alliance [1080501]	$19	103%
Tufts Health Public Plans [1010213]	$19	103%
Wellsense Health Plan Senior Care Options [1020208	$19	103%
Eternal Health [1010322]	$20	109%
Wellsense Health Plan Clarity Connectorcare & Meta	$25	136%
Fallon [1000114]	$26	141%
Harvard Pilgrim [1010602]	$39	212%
Cigna	$42	228%
Tufts [1010701]	$49	266%
Wellpoint [1000102]	$57	310%
Mass General Brigham Health Plan Commercial [10122	$66	359%
Mass General Brigham Health Plan Connectorcare [10	$66	359%
Group Insurance Service Center [1013001]	$70	381%
Innovative Health Plan [1025001]	$70	381%
Priority Health [1015001]	$70	381%
PHCS [1000125]	$76	413%
First Health [1000130]	$89	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 $59.
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 Southcoast Hospitals Group 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.