CMS Price Transparency Data
Blood test, PSA (prostate screen)
Facility: Mercy Hospital Springfield
Billing Code: 84153 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 84153
- Insurance Median: $83
- Cash Discount Price: $135
- vs. Medicare Baseline: 4.51x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Mercy Hospital Springfield is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $135. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 4.51x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$135
Average discount available for prompt cash payment at this facility.
Insurance Median
$83
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: $135 (734%)
Insurance Median: $83 (451%)
Cash: $135 (734% of Medicare)
Ins. Median: $83 (451% 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 451% of the Medicare baseline (a markup of 351%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $14 - $182 | 76% |
| Aetna | $16 - $22 | 87% |
| Humana | $16 - $162 | 87% |
| Medicaid / KanCare | $16 - $35 | 87% |
| Medica Contracted [320239] | $17 | 92% |
| Medica [20239] | $17 | 92% |
| Centurion Of Missouri [20459] | $18 | 98% |
| Champva [20065] | $18 | 98% |
| Cherokee Nation Health Serv Contracted [320066] | $18 | 98% |
| Cigna | $18 - $105 | 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% |
| Indian Health Service Contracted [320198] | $18 | 98% |
| Indian Health Service [20198] | $18 | 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% |
| Mercy Rehab Hospital Contracted [320260] | $18 | 98% |
| Pace Of The Ozarks Contracted [320518] | $18 | 98% |
| Qual Choice Contracted [320325] | $18 | 98% |
| Tricare | $18 | 98% |
| United Medical Resources Contracted [320454] | $18 - $124 | 98% |
| UnitedHealthcare | $18 - $183 | 98% |
| Provider Partners Health Plans Contracted [320450] | $20 | 109% |
| Healthscope Contracted [320182] | $23 | 125% |
| Centivo Contracted [320505] | $30 | 163% |
| Ambetter / Centene | $35 | 190% |
| Home State Health Plan Contracted [320187] | $35 | 190% |
| Novasys Contracted [320285] | $35 | 190% |
| Providrs Care Network Contracted [320484] | $35 | 190% |
| Aither Health Contracted [320449] | $37 - $136 | 201% |
| Auxiant Contracted [320462] | $37 - $155 | 201% |
| Ebms Contracted [320493] | $37 | 201% |
| Healthlink Contracted [320179] | $37 - $110 | 201% |
| Imagine 360 Contracted [320494] | $37 | 201% |
| Mercy Benefit Admin Contracted [320251] | $37 - $136 | 201% |
| Reflect Health Contracted [320492] | $37 | 201% |
| Yuzu Health Contracted [320521] | $37 | 201% |
| Benefit Management Contracted [320052] | $71 - $95 | 386% |
| Health Systems Inc Contracted [320174] | $71 - $95 | 386% |
| Insurance System Inc Contracted [320465] | $71 - $95 | 386% |
| Administrative Payor Contracted [320005] | $80 - $119 | 435% |
| Evolutions Health Care Contracted [320124] | $80 - $107 | 435% |
| Point C Contracted [320238] | $80 - $178 | 435% |
| Point C [20238] | $80 - $107 | 435% |
| Medical Destinations Contracted [320242] | $89 - $119 | 484% |
| Workers Comp [20426] | $89 - $202 | 484% |
| First Health Contracted [320128] | $100 - $133 | 544% |
| Edison Health Solutions Contracted [320502] | $101 - $136 | 549% |
| Federal Medical Center Contracted [320127] | $107 - $143 | 582% |
| 90 Degree Benefits Contracted [320436] | $108 | 587% |
| Show-Me Health Administrators Contracted [320483] | $108 - $113 | 587% |
| Multiplan Contracted [320270] | $137 - $183 | 745% |
| Private Health Care Systems Contracted [320320] | $137 - $183 | 745% |
| Compcare Of The Ozarks Contracted [320437] | $141 - $188 | 767% |
| American Healthcare Alliance Contracted [320020] | $142 - $190 | 772% |
| Qual Choice Contracted [320324] | $142 - $190 | 772% |
| Municipal Health Plan Contracted [320271] | $144 - $193 | 783% |
| Usa Managed Care Org Contracted [320429] | $157 - $209 | 854% |
| Ppo Plus Contracted [320310] | $160 - $214 | 870% |