Blood test, PSA (prostate screen)
Facility: Golden Valley Memorial Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $18
- Cash Discount Price: $60
- vs. Medicare Baseline: 0.98x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $18 | 98% |
| Home State Health | $18 | 98% |
| Humana | $18 | 98% |
| UnitedHealthcare | $18 - $31 | 98% |
| Ambetter / Centene | $22 | 120% |
Consumer Guidance & Cost Commentary
For the Blood test, PSA (prostate screen) procedure at Golden Valley Memorial Hospital in Clinton, MO, the cash median rate is $60, which is significantly higher than the facility's negotiated rate of $18. While the facility is a government-owned acute care hospital with a 3-star rating, patients should note that cash-pay options can sometimes be more expensive than the negotiated rate of $18. Because commercial insurance contracts often include administrative overhead and multi-layered pricing structures, the negotiated rate of $18 may actually represent a lower out-of-pocket cost for those with high-deductible plans, provided their insurance allows payment below the cash price. However, if your plan has a high deductible that you have not yet met, you may be responsible for the full negotiated amount, so verifying your deductible status before scheduling is essential.
To ensure you are receiving fair pricing, it is important to compare these rates against Medicare benchmarks rather than the facility's gross charges. The Medicare amount for this service is $18.39, which serves as a scientifically validated baseline for the true cost of care. Although the facility's cash rate of $60 exceeds the Medicare benchmark, patients should inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by up to 50% for upfront payments. Additionally, since the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, you can avoid unexpected charges by requesting an itemized billing audit to confirm that no unbundled codes or services not rendered are included in your final statement.