CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Lafayette Regional Health Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $19
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Lafayette Regional Health Center is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.03x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

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: $30 (163%)
Insurance Median: $19 (103%)
Cash: $30 (163% of Medicare)
Ins. Median: $19 (103% 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.

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
Ambetter / Centene $6 33%
Nhc Advantage $6 33%
United $8 - $20 44%
Universal Healthcare $8 44%
Humana $10 - $13 54%
Blue Cross Blue Shield $12 - $30 65%
College Park Family Care Center $13 71%
Aetna $14 - $27 76%
Oha Network $15 - $40 82%
Oscar $15 82%
Cigna $17 - $22 92%
Amerigroup $19 103%
Healthyblue $19 103%
Home State Health Plan $19 103%
Medicaid / KanCare $19 103%
Unicare $19 103%
Wppa Providrs Care Network $23 125%
Coventry $24 131%
Coventry Kc Mo $24 131%
Multiplan $24 131%
Cco, Inc. $26 141%
Corvel Corporation $26 - $40 141%
Focus Healthcare Mgmt, Inc $27 147%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals