CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Methodist Medical Center of Oak Ridge

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $34
Cash Discount Price: $16
vs. Medicare Baseline: 1.85x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Methodist Medical Center of Oak Ridge is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.85x the Medicare baseline. Located in 990 Oak Ridge Turnpike Box 529, Oak Ridge, TN.

Cash / Self-Pay

$16

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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: $16 (87%)

Insurance Median: $34 (185%)

Cash: $16 (87% of Medicare)

Ins. Median: $34 (185% 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
Wellpoint	$8 - $19	44%
UnitedHealthcare	$12 - $19	65%
Tricare	$18	98%
Aetna	$19 - $27	103%
Blue Cross Blue Shield	$19 - $39	103%
Cigna	$19 - $39	103%
Devoted Health	$19	103%
Farm Bureau	$19	103%
Humana	$19	103%
Wellcare	$19	103%
Ehn	$23 - $83	125%
Correctional Medical Services	$31 - $111	169%
Community Services Network	$34 - $120	185%
Usa Managed Care Organization	$36 - $130	196%
Novanet	$39 - $139	212%
Direct Care America	$42 - $148	228%
Medsave Usa	$42 - $148	228%
National Provider Network	$42 - $148	228%
Beech Street	$44 - $157	239%
Ccn Managed Care	$44 - $157	239%
Initial Group	$46 - $163	250%
Galaxy Health Network	$47 - $166	256%

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 $16.
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 Methodist Medical Center of Oak Ridge 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.