CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Mercy Hospital Lebanon

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $85
  • Cash Discount Price: $113
  • vs. Medicare Baseline: 4.62x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Mercy Hospital Lebanon is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 4.62x the Medicare baseline. Located in 100 Hospital Drive, Lebanon, MO.
Cash / Self-Pay
$113

Average discount available for prompt cash payment at this facility.

Insurance Median
$85

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: $113 (614%)
Insurance Median: $85 (462%)
Cash: $113 (614% of Medicare)
Ins. Median: $85 (462% 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 462% of the Medicare baseline (a markup of 362%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Medicaid / KanCare $16 - $39 87%
Medica Contracted [320239] $17 92%
Medica [20239] $17 92%
Aetna $18 - $181 98%
Blue Cross Blue Shield $18 - $180 98%
Champva [20065] $18 98%
Cherokee Nation Health Serv Contracted [320066] $18 98%
Cigna $18 - $178 98%
Cross Timbers Hospice [20098] $18 98%
Dept Of Veteran Affairs Contracted [320106] $18 98%
Elara Caring Aspire Hospice [20433] $18 98%
Globalhealth Contracted [320145] $18 98%
Halo Hcr Inc Hospice Contracted [320432] $18 98%
Halo Hcr Inc Hospice [20432] $18 98%
Humana $18 - $205 98%
Kindful Hospice Contracted [320434] $18 98%
Kindful Hospice [20434] $18 98%
Medicare (plans) $18 - $19 98%
Mercy Hospice Okc [20252] $18 98%
Mercy Mgd Behavioral Health Contracted [320259] $18 98%
Pace Of The Ozarks Contracted [320518] $18 98%
Provider Partners Health Plans Contracted [320450] $18 98%
Qual Choice Contracted [320325] $18 98%
Tricare $18 98%
UnitedHealthcare $18 - $229 98%
Healthscope Contracted [320182] $23 125%
United Medical Resources Contracted [320454] $23 - $193 125%
Centivo Contracted [320505] $30 163%
Ambetter / Centene $39 212%
Home State Health Plan Contracted [320187] $39 212%
Novasys Contracted [320285] $39 212%
Administrative Payor Contracted [320005] $48 - $108 261%
Healthlink Contracted [320179] $69 - $205 375%
Preferred Health Plan Contracted [320522] $69 - $157 375%
90 Degree Benefits Contracted [320436] $80 - $181 435%
Mercy Benefit Admin Contracted [320251] $80 - $193 435%
Show-Me Health Administrators Contracted [320483] $80 - $181 435%
Aither Health Contracted [320449] $85 - $193 462%
Auxiant Contracted [320462] $85 - $193 462%
Benefit Management Contracted [320052] $85 - $193 462%
Ebms Contracted [320493] $85 - $193 462%
Edison Health Solutions Contracted [320502] $85 - $193 462%
Evolutions Health Care Contracted [320124] $85 - $193 462%
First Health Contracted [320128] $85 - $193 462%
Health Systems Inc Contracted [320174] $85 - $193 462%
Imagine 360 Contracted [320494] $85 - $193 462%
Insurance System Inc Contracted [320465] $85 - $193 462%
Point C Contracted [320238] $85 - $229 462%
Point C [20238] $85 - $193 462%
Reflect Health Contracted [320492] $85 - $193 462%
Workers Comp [20426] $85 - $205 462%
Yuzu Health Contracted [320521] $85 - $193 462%
American Healthcare Alliance Contracted [320020] $90 - $205 489%
Usa Managed Care Org Contracted [320429] $93 - $212 506%
Multiplan Contracted [320270] $101 - $229 549%
Private Health Care Systems Contracted [320320] $101 - $229 549%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Hospital Drive, Lebanon, MO 65536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals