CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: St Louis Childrens Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $31
Cash Discount Price: $28
vs. Medicare Baseline: 1.69x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at St Louis Childrens Hospital is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.69x the Medicare baseline. Located in One Childrens Place, Saint Louis, MO.

Cash / Self-Pay

$28

Average discount available for prompt cash payment at this facility.

Insurance Median

$31

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: $28 (152%)

Insurance Median: $31 (169%)

Cash: $28 (152% of Medicare)

Ins. Median: $31 (169% 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.

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
Aetna	$18 - $37	98%
UnitedHealthcare	$18 - $35	98%
Blue Cross Blue Shield	$19 - $40	103%
Cox Health [757]	$19	103%
Essence Healthcare [221]	$19	103%
Humana	$19 - $35	103%
Medica [662]	$19	103%
Healthscope Benefits [258]	$22 - $38	120%
Cigna	$23 - $26	125%
Healthlink [225]	$23 - $35	125%
Consociate [478]	$25	136%
Sarah Bush Lincoln [636]	$25	136%
Apwu Health Plan [216]	$26	141%
Cox Health Systems Insurance Company [220]	$26 - $31	141%
Nalc Health Benefit Plan [242]	$26	141%
Priority Health [648]	$26	141%
Allied Benefits [498]	$27 - $37	147%
Hope Trust [806]	$27	147%
Med-Pay [480]	$31 - $35	169%
Unicare [568]	$31 - $35	169%
Health Alliance [224]	$33	179%
Beechstreet [551]	$35	190%
Detego Health [868]	$35	190%
First Health Commercial [734]	$35	190%
Health Systems Inc [620]	$35	190%
Healthcare Sol Mercy [609]	$35	190%
Multiplan Commercial [737]	$35	190%
Multiplan [240]	$35	190%
Phcs [244]	$35 - $38	190%
Preferred Health Professionals [561]	$35	190%
Coresource [497]	$37	201%
Fmh Benefit Service Inc [222]	$37	201%
Mail Handlers [495]	$37	201%
Medica [661]	$38	207%
Hfn [563]	$40	218%

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 $28.
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 St Louis Childrens Hospital 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.