CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Licking Memorial Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $210
  • Cash Discount Price: $279
  • vs. Medicare Baseline: 11.42x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Licking Memorial Hospital is $210. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $279. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 11.42x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$279

Average discount available for prompt cash payment at this facility.

Insurance Median
$210

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: $279 (1517%)
Insurance Median: $210 (1142%)
Cash: $279 (1517% of Medicare)
Ins. Median: $210 (1142% 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 1142% of the Medicare baseline (a markup of 1042%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $18 - $227 98%
Blue Cross Blue Shield $18 - $268 98%
Champva [500001] $18 - $19 98%
Cigna $18 - $280 98%
Humana $18 - $302 98%
Medicare (plans) $18 - $19 98%
Tricare $18 - $19 98%
UnitedHealthcare $18 - $265 98%
Veterans Administration [100068] $18 - $19 98%
Wellcare By Allwell [450104] $18 - $19 98%
Molina Marketplace [100106] $29 - $31 158%
Medical Mutual [100114] $136 - $259 740%
Medben [700068] $173 - $305 941%
Allied Benefit Systems [100015] $178 - $224 968%
Geha [100039] $178 - $224 968%
Gravie Administrative Services [100165] $178 - $224 968%
Meritain [100063] $178 - $224 968%
Optima [700069] $178 - $224 968%
Trustmark Small Business Benefits [100263] $178 - $224 968%
Webtpa [100127] $178 - $224 968%
Benicomp [70090] $185 - $234 1006%
Consociate Health 6 Degrees [100059] $198 - $249 1077%
Consociate Health [100029] $198 - $249 1077%
Healthscope [100157] $210 - $265 1142%
Surest [100016] $210 - $265 1142%
United Medical Resources [700071] $210 - $265 1142%
American Postal Workers [100089] $222 - $280 1207%
Antidote Health Plan Of Ohio [70006803] $222 - $280 1207%
Coresource [100002] $222 - $312 1207%
Great West Life [700064] $222 - $280 1207%
National Association Of Letter Carriers [100067] $222 - $280 1207%
Ohio Healthy Luminare Health [100264] $222 - $280 1207%
Ohio Healthy [100255] $222 - $280 1207%
Ohio Ppo Connect [70006801] $222 - $280 1207%
Osu Prime Care [100254] $222 - $280 1207%
Quality Care Partners [70006802] $222 - $280 1207%
The Health Plan [100261] $222 - $280 1207%
Wellfleet Group, Llc [100164] $222 - $280 1207%
Coventry [100010] $228 - $288 1240%
Pan American Life [700070] $228 - $288 1240%
Ohio Health Choice [100109] $237 - $299 1289%
Administrative Concepts [100006] $240 - $302 1305%
Carefactor [100087] $240 - $302 1305%
Philadelphia American Life [100260] $240 - $312 1305%
Reliance Standard-Asrm [100258] $240 - $302 1305%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals