CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Baylor Scott & White Medical Center at Irving

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $51
Cash Discount Price: $139
vs. Medicare Baseline: 2.77x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Baylor Scott & White Medical Center at Irving is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $139. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 2.77x the Medicare baseline. Located in 1901 N Macarthur Blvd, Irving, TX.

Cash / Self-Pay

$139

Average discount available for prompt cash payment at this facility.

Insurance Median

$51

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: $139 (756%)

Insurance Median: $51 (277%)

Cash: $139 (756% of Medicare)

Ins. Median: $51 (277% 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 277% of the Medicare baseline (a markup of 177%). 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
UnitedHealthcare	$10 - $21	54%
Baylor Scott & White Health Plan	$17 - $135	92%
Aetna	$18 - $128	98%
Humana	$18 - $163	98%
Triwest	$18	98%
American Health Plan	$19	103%
Blue Cross Blue Shield	$19 - $90	103%
Corvel	$19	103%
Healthspring	$19	103%
Prime Health Services	$19	103%
Procare Advantage	$19	103%
Superior Health Plan	$19 - $26	103%
Wellpoint (Fka Amerigroup)	$19 - $26	103%
Ambetter / Centene	$38	207%
Cigna	$114 - $135	620%
Employers Health Network	$128	696%
Quiktrip	$128	696%
University Of Mary Hardin-Baylor	$135	734%
Imagine Health	$145	788%
Curative	$151	821%
First Health	$163	886%
Healthsmart	$163 - $174	886%
Private Health Care System	$174	946%

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 $139.
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 Baylor Scott & White Medical Center at Irving 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.