CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Johnson County Community Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $40
  • Cash Discount Price: $32
  • vs. Medicare Baseline: 2.18x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Johnson County Community Hospital is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 2.18x the Medicare baseline. Located in 1901 S Shady St, Mountain City, TN.
Cash / Self-Pay
$32

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

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: $32 (174%)
Insurance Median: $40 (218%)
Cash: $32 (174% of Medicare)
Ins. Median: $40 (218% 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 218% of the Medicare baseline (a markup of 118%). 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 $14 - $88 76%
Blue Cross Blue Shield $14 - $105 76%
Molina Healthcare $14 - $42 76%
Optima Health $14 76%
UnitedHealthcare $14 - $40 76%
Amerigroup $38 - $40 207%
Cigna $40 - $73 218%
Managed Medicaire $40 218%
Medicare (plans) $40 218%
Sentara Health $40 - $47 218%
United Mine Workers Of America $40 218%
Wellcare $40 218%
Humana $41 223%
Devoted Health Plan $42 228%
Nhc Advantage $42 228%
Ambetter / Centene $44 239%
Medcost $48 261%
First Health Coventry $104 566%
Seven Corners, Inc. $138 750%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 S Shady St, Mountain City, TN 37683
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals