CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Charlevoix Area Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $33
Cash Discount Price: $35
vs. Medicare Baseline: 1.79x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Charlevoix Area Hospital is $33. 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 1.79x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.

Cash / Self-Pay

$35

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $33 (179%)

Cash: $35 (190% of Medicare)

Ins. Median: $33 (179% 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	$6 - $127	33%
Blue Care Network	$6 - $66	33%
Hap (Health Alliance Plan)	$6 - $113	33%
Mclaren Health Plan	$6 - $131	33%
Medicare (plans)	$6 - $66	33%
Michigan Amish Medical Board	$6 - $66	33%
Molina	$6 - $72	33%
Northern Michigan Mennonite Group	$6 - $66	33%
Priority Health	$6 - $141	33%
UnitedHealthcare	$6 - $123	33%
Hospice Of Michigan	$8 - $85	44%
Asr Physicians Care Network	$10 - $113	54%
Employee Benefits Logistics	$10 - $113	54%
Enterprise Group Planning Employee Benefit Plan	$10 - $113	54%
First Health/Coventry Health/Community Care Network	$10 - $113	54%
Medical Cost Savings Solution	$10 - $113	54%
Provider Network Of America/Hma Group Health	$11 - $120	60%
Three Rivers Provider Network	$11 - $120	60%
Blue Cross Blue Shield	$12 - $130	65%
Cofinity	$12 - $131	65%
Iba Health And Life Assurance Company	$12 - $130	65%
Nomi Health	$12 - $131	65%
Preferred Medical Claim Solutions	$12 - $134	65%
Cigna	$13 - $141	71%
Meridian	$13	71%

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 Charlevoix Area 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.