CMS Price Transparency Data
Blood test, PSA (prostate screen)
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 84153 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 84153
- Insurance Median: $28
- Cash Discount Price: $53
- vs. Medicare Baseline: 1.52x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Saint Alphonsus Medical Center Ontario is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $53. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.52x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$53
Average discount available for prompt cash payment at this facility.
Insurance Median
$28
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: $53 (288%)
Insurance Median: $28 (152%)
Cash: $53 (288% of Medicare)
Ins. Median: $28 (152% 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 |
|---|---|---|
| Medicaid / KanCare | $13 - $28 | 71% |
| Blue Cross Blue Shield | $18 - $78 | 98% |
| Medicare (plans) | $18 - $19 | 98% |
| UnitedHealthcare | $18 - $88 | 98% |
| Aetna | $19 - $87 | 103% |
| American Health Advantage Of Idaho | $19 | 103% |
| Healthnet | $19 | 103% |
| Ada County Jail Inmate Ins | $22 - $28 | 120% |
| Ambetter / Centene | $22 - $28 | 120% |
| Amish Mennonite | $22 - $28 | 120% |
| Bcccp-Michigan | $22 - $28 | 120% |
| Bccp | $22 - $28 | 120% |
| Bmc Healthnet | $22 - $28 | 120% |
| Breast Grant-Connecticut | $22 - $28 | 120% |
| California Health And Wellness | $22 - $28 | 120% |
| Cardinal Innovations Lme | $22 - $28 | 120% |
| Care Oregon Ohp | $22 - $28 | 120% |
| Cencal Health Plan | $22 - $28 | 120% |
| Cenpatico | $22 - $28 | 120% |
| Centurion Of Idaho | $22 - $28 | 120% |
| Chhuny | $22 - $28 | 120% |
| Childrens Comm Health Plan | $22 - $28 | 120% |
| Childrens Medical Services Title 19 | $22 - $28 | 120% |
| Cigna | $22 - $86 | 120% |
| Community Benefit Health | $22 - $28 | 120% |
| Community Care Behavorial Health | $22 - $28 | 120% |
| Community Health Choice | $22 - $28 | 120% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $22 - $28 | 120% |
| Dean Wi Badgercare | $22 - $28 | 120% |
| Delaware First Health | $22 - $28 | 120% |
| Delta Dental Nj | $22 - $28 | 120% |
| Dph Tb Program | $22 - $28 | 120% |
| Dscc | $22 - $28 | 120% |
| Eastpointe Lme | $22 - $28 | 120% |
| Family Health Network | $22 - $28 | 120% |
| Freedom First Healthcare | $22 - $28 | 120% |
| Ghc Scw Wi Badgercare | $22 - $28 | 120% |
| Harbor Health | $22 - $28 | 120% |
| Health Safety Net | $22 - $28 | 120% |
| Healthy Blue Ne | $22 - $28 | 120% |
| Hennepin Health | $22 - $28 | 120% |
| Humana | $22 - $81 | 120% |
| Id County Ada | $22 - $28 | 120% |
| Id County Canyon | $22 - $28 | 120% |
| Id County Cat Fund | $22 - $28 | 120% |
| Id County Payette | $22 - $28 | 120% |
| Idaho Womens Health Check | $22 - $28 | 120% |
| Indiana Breast Cervical Cancer | $22 - $28 | 120% |
| Inland Empire Health Plan | $22 - $28 | 120% |
| Intercommunity Health Ohp | $22 - $28 | 120% |
| Iowa Total Care | $22 - $28 | 120% |
| Jai Medical System | $22 - $28 | 120% |
| Kern Family Health Plan | $22 - $28 | 120% |
| Keystone First | $22 - $28 | 120% |
| Keystone First Chip | $22 - $28 | 120% |
| La Care Health Plan | $22 - $28 | 120% |
| Lakeland Care Inc | $22 - $28 | 120% |
| Managed Health Services - Indiana | $22 - $28 | 120% |
| Maryland Breast & Cervical Program | $22 - $28 | 120% |
| Maryland Healthy Smiles - Scion Dental | $22 - $28 | 120% |
| Maryland Physicians Care | $22 - $28 | 120% |
| Massachusetts Behavioral Health Partnership | $22 - $28 | 120% |
| Mdwise | $22 - $28 | 120% |
| Medi-Cal | $22 - $28 | 120% |
| Medi-Cal Healthnet | $22 - $28 | 120% |
| Medstar Dc Healthy Family | $22 - $28 | 120% |
| Medstar Md Health Choice | $22 - $28 | 120% |
| Mo Home State Health Plan | $22 - $28 | 120% |
| Molina Centennial Care | $22 - $28 | 120% |
| Nascentia Health Options | $22 - $28 | 120% |
| Nebraska Total Care | $22 - $28 | 120% |
| New York Cancer Services Program | $22 - $28 | 120% |
| Nextlevel Health | $22 - $28 | 120% |
| Oregon Screenwise | $22 - $28 | 120% |
| Pace Of Southwest Michigan | $22 - $28 | 120% |
| Paramount Advantage | $22 - $28 | 120% |
| Parkland Community Health Plan | $22 - $28 | 120% |
| Partners Behavioral Lme | $22 - $28 | 120% |
| Peach State Healthplan | $22 - $28 | 120% |
| Presbyterian Centennial Care | $22 - $28 | 120% |
| Prestige Health Choice | $22 - $28 | 120% |
| Priority Partners | $22 - $28 | 120% |
| Rx 340B Pass Along | $22 - $28 | 120% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $22 - $28 | 120% |
| Rx Medi-Cal | $22 - $28 | 120% |
| Rx Meridian Rx | $22 - $28 | 120% |
| Sandhills Center Lme | $22 - $28 | 120% |
| Screening For Life | $22 - $28 | 120% |
| Sunshine State Health Plan | $22 - $28 | 120% |
| Superior Health | $22 - $28 | 120% |
| Tenncare | $22 - $28 | 120% |
| Texas Children'S Health Plan | $22 - $28 | 120% |
| Trillium Community Ohp | $22 - $28 | 120% |
| Tufts Health Public Plans | $22 - $28 | 120% |
| Vaya Health Lme | $22 - $28 | 120% |
| Wellsense Health Plan | $22 - $28 | 120% |
| Wi Womens Wellness | $22 - $28 | 120% |
| Healthcare Management Admin | $31 | 169% |
| Blue Benefit Administrators Of Massachusetts | $32 | 174% |
| Blue Care Network | $32 | 174% |
| Blue Distinction Transplant | $32 | 174% |
| Blue Shield - Ca | $32 | 174% |
| Blue Shield - Id (Regence) | $32 | 174% |
| Blue Shield - Ny Highmark Northeastern | $32 | 174% |
| Blue Shield - Ny Highmark Western | $32 | 174% |
| Blue Shield - Pa (Highmark) | $32 | 174% |
| Blue Shield - Wa (Regence) | $32 | 174% |
| Moda Health | $36 - $89 | 196% |
| Mountain Health Co-Op | $43 - $55 | 234% |
| Pacificsource Health Plans | $43 - $86 | 234% |
| Selecthealth | $45 - $83 | 245% |
| Webtpa | $49 - $83 | 266% |
| Allegiance | $55 - $70 | 299% |
| Correctional Health Partners | $56 - $72 | 305% |
| Columbia Health Network | $58 - $74 | 315% |
| Allied National Global Care | $65 - $83 | 353% |
| Asrm - Reliance Standard Life Insurance | $65 - $83 | 353% |
| Christian Care Ministry | $65 - $83 | 353% |
| Dean Health | $65 - $83 | 353% |
| Fallon Health | $65 - $83 | 353% |
| Family Life Insurance Company | $65 - $83 | 353% |
| First Choice Health | $65 - $83 | 353% |
| Ghc Scw | $65 - $83 | 353% |
| International Benefit Administrators | $65 - $83 | 353% |
| Lifetime Benefit Solutions | $65 - $83 | 353% |
| Manhattan Life | $65 - $83 | 353% |
| Pai | $65 - $83 | 353% |
| Pan-American Life | $65 - $83 | 353% |
| Paramount Hmo | $65 - $83 | 353% |
| Phcs | $65 - $83 | 353% |
| Trinity Health Share | $65 - $83 | 353% |
| Lifewise | $67 - $86 | 364% |
| Allied Benefit Systems | $68 - $87 | 370% |
| Ameriben | $68 - $87 | 370% |
| Asr Health Benefits | $68 - $87 | 370% |
| Christian Brother Services | $68 - $87 | 370% |
| First Health | $68 - $87 | 370% |
| Geha | $68 - $88 | 370% |
| Healthez | $68 - $87 | 370% |
| Luminare Health (Detroit) | $68 - $87 | 370% |
| Medi Share | $68 - $87 | 370% |
| Priority Health | $68 - $86 | 370% |
| Providence | $68 - $87 | 370% |
| Rural Carrier Health Benefit Plan | $68 - $87 | 370% |