CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Texas Orthopedic Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $20
  • Cash Discount Price: $548
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Texas Orthopedic Hospital is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $548. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.09x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
$548

Average discount available for prompt cash payment at this facility.

Insurance Median
$20

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: $548 (2980%)
Insurance Median: $20 (109%)
Cash: $548 (2980% of Medicare)
Ins. Median: $20 (109% 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
Amerigroup $15 - $18 82%
Community Health Choice Mcd $15 82%
Texas Childrens Health Plans $15 - $91 82%
Texas Health Network $15 82%
United $16 - $247 87%
Aetna $17 - $106 92%
Molina Healthcare $17 - $40 92%
Blue Cross Blue Shield $18 - $192 98%
Cigna $18 - $97 98%
Devoted Health $18 98%
Humana $18 - $246 98%
Kelsey Seybold $18 98%
Oscar $18 - $53 98%
Triwest Healthcare Alliance $18 98%
Wellmed $18 98%
American Health Plan $19 103%
Integranet Amerigroup Ipa $19 103%
Procare Advantage $19 103%
Provider Partners Health Plan Of Texas $19 103%
Shared Health $19 103%
Superior Health Plan $19 - $33 103%
Van Lang Ipa $19 103%
Wellcare $19 103%
Christus (Usfhp) $20 109%
Molina $20 109%
Universal Healthcare Group $22 120%
Verda Health Plan $24 131%
Community Health Choice $27 147%
Superior $27 - $28 147%
Corvel Corporation $36 196%
Omni Healthcare $39 212%
Healthcare Highways $55 299%
Texas Workforce Commission $131 712%
Evry Health $150 816%
Imagine Health $192 1044%
Healthsmart Preferred Care $236 - $466 1283%
Averde Health $247 1343%
Fidelis Securecare Of Tx $247 1343%
Coventry National First Health $292 1588%
Physicians Cooperative Of Texas $301 1637%
Rockport Workers Comp $301 1637%
Independent Medical System $329 1789%
National Healthcare Solutions $329 1789%
Southwest Medical $329 1789%
Coastal Comp $356 1936%
Multiplan $411 - $466 2235%
International Health Insurance $438 2382%
Physicians, Inc $466 2534%
Affiliated Ppo $493 2681%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals