CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Ira Davenport Memorial Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $195
Cash Discount Price: $189
vs. Medicare Baseline: 10.60x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Ira Davenport Memorial Hospital is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $189. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 10.60x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$189

Average discount available for prompt cash payment at this facility.

Insurance Median

$195

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: $189 (1028%)

Insurance Median: $195 (1060%)

Cash: $189 (1028% of Medicare)

Ins. Median: $195 (1060% 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 1060% of the Medicare baseline (a markup of 960%). 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
Empire	$8	44%
Blue Cross Blue Shield	$12 - $948	65%
Humana	$18 - $281	98%
Tricare	$18	98%
Amerihealth Caritas Mcr Adv - All Plans	$19	103%
Fidelis	$19	103%
UnitedHealthcare	$38 - $328	207%
Fidelis Care - Exchange - All Plans	$172	935%
Geisinger - All Plans	$182	990%
Cigna	$195	1060%
Mvp Health Plan - All Plans	$195	1060%
Independent Health - All Plans	$203	1104%
Upmc - All Plans	$216	1175%
Pomco Inc - All Plans	$225	1223%
Aetna	$234 - $279	1272%
Emblem Health - All Plans	$275	1495%
Emblem/Ghi	$289	1572%
Martins Point - All Plans	$312	1697%
Healthnow - All Plans	$1,029	5595%

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 $189.
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 Ira Davenport 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.