CMS Price Transparency Data
Blood test, PSA (prostate screen)
Facility: Mercy Hospital Carthage
Billing Code: 84153 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 84153
- Insurance Median: $125
- Cash Discount Price: $137
- vs. Medicare Baseline: 6.80x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Mercy Hospital Carthage is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $137. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 6.80x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.
Cash / Self-Pay
$137
Average discount available for prompt cash payment at this facility.
Insurance Median
$125
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: $137 (745%)
Insurance Median: $125 (680%)
Cash: $137 (745% of Medicare)
Ins. Median: $125 (680% 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 680% of the Medicare baseline (a markup of 580%). 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.
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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 | $16 - $197 | 87% |
| Humana | $16 - $66 | 87% |
| Medicaid / KanCare | $16 - $121 | 87% |
| Blue Cross Blue Shield | $18 - $73 | 98% |
| Medicare (plans) | $18 - $65 | 98% |
| UnitedHealthcare | $25 - $192 | 136% |
| United Medical Resources Contracted [320454] | $26 - $199 | 141% |
| Cherokee Nation Health Serv Contracted [320066] | $55 - $61 | 299% |
| Cigna | $55 - $199 | 299% |
| Cross Timbers Hospice [20098] | $55 - $61 | 299% |
| Dept Of Veteran Affairs Contracted [320106] | $55 - $61 | 299% |
| Elara Caring Aspire Hospice [20433] | $55 - $61 | 299% |
| Globalhealth Contracted [320145] | $55 - $61 | 299% |
| Halo Hcr Inc Hospice Contracted [320432] | $55 - $61 | 299% |
| Halo Hcr Inc Hospice [20432] | $55 - $61 | 299% |
| Indian Health Service Contracted [320198] | $55 - $61 | 299% |
| Kindful Hospice Contracted [320434] | $55 - $61 | 299% |
| Kindful Hospice [20434] | $55 - $61 | 299% |
| Medical Associates Health Contracted [320444] | $55 - $61 | 299% |
| Mercy Hospice Okc [20252] | $55 - $61 | 299% |
| Mercy Mgd Behavioral Health Contracted [320259] | $55 - $61 | 299% |
| Pace Of The Ozarks Contracted [320518] | $55 - $61 | 299% |
| Provider Partners Health Plans Contracted [320450] | $55 - $61 | 299% |
| Qual Choice Contracted [320325] | $55 - $61 | 299% |
| Tricare | $55 - $61 | 299% |
| Point C Contracted [320238] | $70 - $199 | 381% |
| Health Systems Inc Contracted [320174] | $86 - $95 | 468% |
| Insurance System Inc Contracted [320465] | $86 - $95 | 468% |
| Administrative Payor Contracted [320005] | $90 - $99 | 489% |
| Centivo Contracted [320505] | $92 - $102 | 500% |
| Healthscope Contracted [320182] | $104 - $115 | 566% |
| Ambetter / Centene | $109 - $121 | 593% |
| Home State Health Plan Contracted [320187] | $109 - $121 | 593% |
| Novasys Contracted [320285] | $109 - $121 | 593% |
| Benefit Management Contracted [320052] | $119 - $192 | 647% |
| Auxiant Contracted [320462] | $129 - $188 | 701% |
| Healthlink Contracted [320179] | $129 - $206 | 701% |
| Preferred Health Plan Contracted [320522] | $129 - $144 | 701% |
| Workers Comp [20426] | $159 - $221 | 865% |
| 90 Degree Benefits Contracted [320436] | $169 - $188 | 919% |
| Aither Health Contracted [320449] | $169 - $188 | 919% |
| Ebms Contracted [320493] | $169 - $188 | 919% |
| Edison Health Solutions Contracted [320502] | $169 - $188 | 919% |
| Imagine 360 Contracted [320494] | $169 - $188 | 919% |
| Mercy Benefit Admin Contracted [320251] | $169 - $199 | 919% |
| Reflect Health Contracted [320492] | $169 - $188 | 919% |
| Show-Me Health Administrators Contracted [320483] | $169 - $188 | 919% |
| Yuzu Health Contracted [320521] | $169 - $188 | 919% |
| Medica Contracted [320239] | $172 - $191 | 935% |
| Evolutions Health Care Contracted [320124] | $173 - $192 | 941% |
| First Health Contracted [320128] | $173 - $192 | 941% |
| Multiplan Contracted [320270] | $173 - $192 | 941% |
| Private Health Care Systems Contracted [320320] | $173 - $192 | 941% |
| American Healthcare Alliance Contracted [320020] | $179 - $199 | 973% |
| Ppo Plus Contracted [320310] | $179 - $199 | 973% |
| Usa Managed Care Org Contracted [320429] | $179 - $199 | 973% |