CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Mercy Hospital Aurora

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $151
Cash Discount Price: $116
vs. Medicare Baseline: 8.21x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Mercy Hospital Aurora is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 8.21x the Medicare baseline. Located in 500 Porter Avenue, Aurora, MO.

Cash / Self-Pay

$116

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

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: $116 (631%)

Insurance Median: $151 (821%)

Cash: $116 (631% of Medicare)

Ins. Median: $151 (821% 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 821% of the Medicare baseline (a markup of 721%). 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
Medicaid / KanCare	$18 - $90	98%
Medicare (plans)	$19 - $53	103%
Blue Cross Blue Shield	$25 - $178	136%
UnitedHealthcare	$25 - $169	136%
Aetna	$51 - $158	277%
Cherokee Nation Health Serv Contracted [320066]	$51	277%
Cigna	$51 - $151	277%
Cross Timbers Hospice [20098]	$51	277%
Elara Caring Aspire Hospice [20433]	$51	277%
Globalhealth Contracted [320145]	$51	277%
Halo Hcr Inc Hospice Contracted [320432]	$51	277%
Halo Hcr Inc Hospice [20432]	$51	277%
Humana	$51 - $151	277%
Indian Health Service Contracted [320198]	$51	277%
Kindful Hospice Contracted [320434]	$51	277%
Kindful Hospice [20434]	$51	277%
Medical Associates Health Contracted [320444]	$51	277%
Mercy Hospice Okc [20252]	$51	277%
Mercy Mgd Behavioral Health Contracted [320259]	$51	277%
Pace Of The Ozarks Contracted [320518]	$51	277%
Provider Partners Health Plans Contracted [320450]	$51	277%
Qual Choice Contracted [320325]	$51	277%
Dept Of Veteran Affairs Contracted [320106]	$52	283%
Tricare	$52	283%
Healthscope Contracted [320182]	$66	359%
Centivo Contracted [320505]	$71	386%
Administrative Payor Contracted [320005]	$80	435%
Ambetter / Centene	$90	489%
Home State Health Plan Contracted [320187]	$90	489%
Novasys Contracted [320285]	$90	489%
Healthlink Contracted [320179]	$116 - $160	631%
Preferred Health Plan Contracted [320522]	$116	631%
Health Systems Inc Contracted [320174]	$142	772%
Insurance System Inc Contracted [320465]	$142	772%
Point C Contracted [320238]	$142 - $151	772%
Point C [20238]	$142	772%
Workers Comp [20426]	$142 - $151	772%
90 Degree Benefits Contracted [320436]	$151	821%
Aither Health Contracted [320449]	$151	821%
American Healthcare Alliance Contracted [320020]	$151	821%
Auxiant Contracted [320462]	$151	821%
Benefit Management Contracted [320052]	$151	821%
Ebms Contracted [320493]	$151	821%
Edison Health Solutions Contracted [320502]	$151	821%
Evolutions Health Care Contracted [320124]	$151	821%
First Health Contracted [320128]	$151	821%
Imagine 360 Contracted [320494]	$151	821%
Medica Contracted [320239]	$151	821%
Mercy Benefit Admin Contracted [320251]	$151	821%
Reflect Health Contracted [320492]	$151	821%
Show-Me Health Administrators Contracted [320483]	$151	821%
United Medical Resources Contracted [320454]	$151 - $157	821%
Yuzu Health Contracted [320521]	$151	821%
Usa Managed Care Org Contracted [320429]	$157	854%
Multiplan Contracted [320270]	$169	919%
Private Health Care Systems Contracted [320320]	$169	919%

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 $116.
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 Mercy Hospital Aurora 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.