CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: North Memorial Health Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $20
Cash Discount Price: $22
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at North Memorial Health Hospital is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.09x the Medicare baseline. Located in 3300 Oakdale North, Robbinsdale, MN.

Cash / Self-Pay

$22

Average discount available for prompt cash payment at this facility.

Insurance Median

$20

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: $22 (120%)

Insurance Median: $20 (109%)

Cash: $22 (120% of Medicare)

Ins. Median: $20 (109% 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
Medica [1086]	$13 - $31	71%
Blue Cross Blue Shield	$18 - $19	98%
Health Partners [1061]	$18 - $68	98%
Humana	$18	98%
Medicaid / KanCare	$18	98%
Medicare (plans)	$18	98%
UnitedHealthcare	$18 - $19	98%
Ucare [1148]	$19 - $33	103%
Aetna	$20 - $38	109%
America'S Ppo [1010]	$22 - $37	120%
Phcs [1172]	$25 - $38	136%
Multiplan [1176]	$26 - $41	141%
Cigna	$72	392%

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 $22.
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 North Memorial Health 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.