CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Bay Area Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $65
Cash Discount Price: $55
vs. Medicare Baseline: 3.53x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Bay Area Hospital is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 3.53x the Medicare baseline. Located in 1775 Thompson Road, Coos Bay, OR.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$65

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: $55 (299%)

Insurance Median: $65 (353%)

Cash: $55 (299% of Medicare)

Ins. Median: $65 (353% 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 353% of the Medicare baseline (a markup of 253%). 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
Aetna	$8 - $27	44%
Southwest Oregon Ipa - All Plans	$15	82%
Healthnet Mcaid	$18	98%
Healthnet Mcr Adv	$20	109%
Moda Hlth Mcr Adv	$20	109%
Nasomah Hlth Grp - All Plans	$27 - $88	147%
Pacificsource - All Plans	$38 - $125	207%
Moda Connexus/Synergy	$40 - $131	218%
Cigna	$41 - $135	223%
First Choice - All Plans	$41 - $134	223%
Providence - All Other Plans	$42 - $137	228%
Healthnet Comm- All Other Plans	$43 - $140	234%
UnitedHealthcare	$43 - $140	234%
Moda Beacon - All Other Plans	$50	272%
Providence Pebb	$71	386%
Ods Ppo/Pos - All Plans	$72	392%
Blue Cross Blue Shield	$161 - $526	875%

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 $55.
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 Bay Area 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.