CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $26
Cash Discount Price: $35
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Munson Healthcare Otsego Memorial Hospital is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.41x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$35

Average discount available for prompt cash payment at this facility.

Insurance Median

$26

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: $35 (190%)

Insurance Median: $26 (141%)

Cash: $35 (190% of Medicare)

Ins. Median: $26 (141% 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
UnitedHealthcare	$6 - $54	33%
Blue Cross Blue Shield	$8 - $42	44%
Hospice Of Michigan	$8 - $41	44%
Munson Hospice	$9 - $852	49%
Aetna	$10 - $55	54%
Asr Physicians Care Network	$10 - $54	54%
Enterprise Group Planning/Employee Benefit Plan	$10 - $54	54%
Hap (Health Alliance Plan)	$10 - $54	54%
Mclaren Health Plan	$10 - $57	54%
Meridian	$10	54%
Molina	$10 - $20	54%
Nomi Health	$10 - $54	54%
Priority Health	$10 - $35	54%
Cofinity	$11 - $61	60%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$11 - $58	60%
Three Rivers Provider Network	$11 - $58	60%
Blue Care Network	$18	98%
Humana	$18	98%
Medicare (plans)	$18	98%
Michigan Amish Medical Board	$18	98%
Northern Michigan Mennonite Group	$18	98%
Cigna	$19 - $35	103%
Employee Benefit Logistics	$31	169%

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 $35.
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 Munson Healthcare Otsego 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.