CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Great Plains Health

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $148
Cash Discount Price: $95
vs. Medicare Baseline: 8.05x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Great Plains Health is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 8.05x the Medicare baseline. Located in 601 West Leota St, North Platte, NE.

Cash / Self-Pay

$95

Average discount available for prompt cash payment at this facility.

Insurance Median

$148

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: $95 (517%)

Insurance Median: $148 (805%)

Cash: $95 (517% of Medicare)

Ins. Median: $148 (805% 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 805% of the Medicare baseline (a markup of 705%). 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
Midwest Network Alliance	$134 - $139	729%
Blue Cross Blue Shield	$141	767%
Ambetter / Centene	$146	794%
Medica	$146	794%
Midlands Choice	$148	805%
Oscar Health	$148	805%
Coventry	$149 - $151	810%
Geha	$149	810%
Mutual Of Omaha	$151	821%
UnitedHealthcare	$151	821%

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 $95.
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 Great Plains Health 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.