CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Perham Health

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $59
Cash Discount Price: $105
vs. Medicare Baseline: 3.21x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Perham Health is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 3.21x the Medicare baseline. Located in 1000 Coney Street West, Perham, MN.

Cash / Self-Pay

$105

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $105 (571%)

Insurance Median: $59 (321%)

Cash: $105 (571% of Medicare)

Ins. Median: $59 (321% 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 321% of the Medicare baseline (a markup of 221%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$45 - $110	245%
Health Partners Mcr Adv	$55	299%
Humana	$55	299%
Medica Mcr Adv	$55	299%
Medicare (plans)	$55 - $62	299%
Ucare Mn Senior Health Options	$55	299%
UnitedHealthcare	$56 - $127	305%
Ucare Mn Special Needs Basic Care Dual	$57 - $58	310%
Medicaid / KanCare	$58 - $59	315%
Ucare Mn Medical Assistance	$58 - $59	315%
Ucare Mn Minnesota Care	$58 - $59	315%
Ucare Mn Senior Care Plus	$58 - $59	315%
Ucare Mn Special Needs Basic Care	$58 - $59	315%
Medica Mcaid Mn Care	$59 - $60	321%
Medica Mn (Msho)	$66 - $67	359%
Ucare Individual And Family Plan-All Other Plans	$67	364%
Medica Mn Senior Hp/Outside Mn	$73 - $74	397%
Health Partners Minnesota Care	$80 - $82	435%
Medica Commercial-All Other Plans	$118 - $119	642%
Preferred One (Pchp, Pic, Pas)-All Other Plans	$121 - $122	658%
Health Partners-All Plans	$132 - $134	718%
Preferred One (Ppo)	$137 - $139	745%
Sanford Health Plan-All Plans	$137 - $139	745%

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 $105.
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 Perham Health 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.