CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Rio Grande Regional Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $25
  • Cash Discount Price: $1,529
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Rio Grande Regional Hospital is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,529. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.36x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
$1,529

Average discount available for prompt cash payment at this facility.

Insurance Median
$25

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: $1,529 (8314%)
Insurance Median: $25 (136%)
Cash: $1,529 (8314% of Medicare)
Ins. Median: $25 (136% 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
Texas Health Network $15 82%
Driscoll Children'S Health Plan $16 87%
United $16 - $688 87%
Aetna $17 - $19 92%
Molina Healthcare $17 - $45 92%
Allegian Health $18 - $612 98%
Blue Cross Blue Shield $18 - $688 98%
Cigna $18 - $67 98%
Humana $18 - $64 98%
Independent Medical System $18 98%
Triwest Healthcare Alliance $18 98%
Wellmed $18 98%
American Health Plan $19 103%
Physicians Health Choice $19 103%
Prominence Health $19 103%
Provider Partners Health Plan Of Texas $19 103%
Shared Health $19 103%
Superior Health Plan $19 - $107 103%
Molina $20 109%
Triwest Health Alliance $20 109%
Universal Health Care $22 120%
Superior $28 152%
Corvel Corporation $36 196%
Focus Healthcare $37 201%
Omni Healthcare $39 212%
Oscar $43 234%
Healthcare Highways $55 299%
Texas Workforce Commission $367 1996%
Averde Health $505 2746%
Healthsmart Preferred Care $658 - $1,300 3578%
First Health $879 4780%
National Healthcare Solutions $918 4992%
Southwest Medical $918 4992%
Coastal Comp $994 5405%
Usa Managed Care $994 - $1,223 5405%
Ppo Next/ Medical Control $1,147 6237%
Beech Street $1,223 6650%
Multiplan $1,223 6650%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 E Ridge Rd, McAllen, TX 78503
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals