CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Wheatland Memorial Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $181
Cash Discount Price: $190
vs. Medicare Baseline: 9.84x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Wheatland Memorial Hospital is $181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 9.84x the Medicare baseline. Located in 530 3Rd St Nw, Harlowton, MT.

Cash / Self-Pay

$190

Average discount available for prompt cash payment at this facility.

Insurance Median

$181

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: $190 (1033%)

Insurance Median: $181 (984%)

Cash: $190 (1033% of Medicare)

Ins. Median: $181 (984% 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 984% of the Medicare baseline (a markup of 884%). 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
Healthnet Federal-All Plans	$116	631%
Humana	$116	631%
Medica Prime Solutions-All Plans	$116	631%
Pacific Source Mcr Adv	$116	631%
Triwest-All Plans	$116	631%
Amish Old Orders-All Plans	$142	772%
Allegiance Provider-All Plans	$162	881%
6 Degrees Health-All Plans	$180	979%
Americas Choice-All Plans	$180	979%
Community Health Ntwk-All Plans	$180	979%
Fedmed Network-All Plans	$180	979%
First Choice Big Sky-All Plans	$180	979%
Interwest Ppo-All Plans	$180	979%
Mountain Health Co-Op-All Plans	$180	979%
Pacific Source-All Other Plans	$180	979%
Pacific Steel & Recycling-All Plans	$180	979%
Rocky Mountain Health Network-All Plans	$180	979%
Three Rivers-All Plans	$180	979%
First Health-All Plans	$182	990%
Ccn-All Plans	$184	1001%
UnitedHealthcare	$186	1011%
City Of Billings-All Plans	$285	1550%

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 $190.
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 Wheatland Memorial 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.