CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $36
  • Cash Discount Price: $28
  • vs. Medicare Baseline: 1.96x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Mary Hitchcock Memorial Hospital is $36. 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 1.96x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.
Cash / Self-Pay
$28

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $36 (196%)
Cash: $28 (152% of Medicare)
Ins. Median: $36 (196% 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
Amerihealth Caritas Nh $6 - $16 33%
Beacon Health Strategies/Carelon $7 - $16 38%
Granite State Health Plan $7 - $17 38%
Wellsense Health Plan $7 - $19 38%
UnitedHealthcare $8 - $98 44%
Blue Cross Blue Shield $12 - $132 65%
Harvard Pilgrim Health Care Of Ne $18 - $81 98%
Martin'S Point Generations Advantage $18 98%
Mvp $18 - $85 98%
Aetna $19 - $89 103%
Ambetter / Centene $19 - $60 103%
Cigna $19 - $110 103%
Martin'S Point Health Care $19 - $44 103%
Wellcare Health Plans $19 103%
Mass General Brigham Health Plan $32 - $79 174%
Tufts Health Plan $32 - $74 174%
Maine Community Health Options $36 - $93 196%
Coventry $49 - $110 266%
First Health/Hcvm $49 - $110 266%
Phcs $50 - $114 272%
Corvel $52 - $117 283%
Ccmsi $53 - $121 288%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Medical Center Drive, Lebanon, NH 03756
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals