CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Alice Peck Day Memorial Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $92
Cash Discount Price: $69
vs. Medicare Baseline: 5.00x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Alice Peck Day Memorial Hospital is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 5.00x the Medicare baseline. Located in 10 Alice Peck Day Drive, Lebanon, NH.

Cash / Self-Pay

$69

Average discount available for prompt cash payment at this facility.

Insurance Median

$92

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: $69 (375%)

Insurance Median: $92 (500%)

Cash: $69 (375% of Medicare)

Ins. Median: $92 (500% 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 500% of the Medicare baseline (a markup of 400%). 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
Ambetter / Centene	$12	65%
Amerihealth Caritas Granite Mcmp	$13	71%
Medicaid / KanCare	$13	71%
Nh Healthy Families	$13	71%
Blue Cross Blue Shield	$28 - $150	152%
Harvard Pilgrim	$35 - $146	190%
UnitedHealthcare	$40 - $121	218%
Tufts	$41 - $123	223%
Cigna	$43 - $137	234%
Commercial Generic	$43 - $129	234%
Connecticut General	$43 - $129	234%
Klais	$43 - $130	234%
Aetna	$50 - $151	272%
Mvp	$51 - $153	277%
Coventry Health	$53 - $160	288%
Coventry Health Wc	$53 - $160	288%
Wellpoint	$56 - $107	305%
Humana	$58 - $175	315%

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 $69.
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 Alice Peck Day 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.