CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Memorial Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $25
Cash Discount Price: $103
vs. Medicare Baseline: 1.36x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Memorial Hospital is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $103. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.36x the Medicare baseline. Located in 715 South Taft Avenue, Fremont, OH.

Cash / Self-Pay

$103

Average discount available for prompt cash payment at this facility.

Insurance Median

$25

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: $103 (560%)

Insurance Median: $25 (136%)

Cash: $103 (560% of Medicare)

Ins. Median: $25 (136% 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.

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
Meridian Health Plan Of Mi	$10 - $133	54%
Humana	$14 - $18	76%
Aetna	$16 - $222	87%
Summacare	$16 - $123	87%
Blue Cross Blue Shield	$18 - $108	98%
Buckeye Community Health Plan	$18 - $133	98%
Caresource	$18 - $29	98%
Frontpath	$18 - $97	98%
Health Alliance Plan	$18 - $103	98%
Molina Healthcare Of Ohio	$18 - $278	98%
Paramount Healthcare Inc	$18 - $88	98%
UnitedHealthcare	$19 - $125	103%
Amerihealth	$21 - $46	114%
Cigna	$21 - $110	114%
Medical Mutual Of Ohio	$21 - $106	114%
Multiplan	$21 - $142	114%
Health Ohio Network	$23 - $109	125%

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 $103.
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 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.