CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: North Austin Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $101
  • Cash Discount Price: $573
  • vs. Medicare Baseline: 5.49x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at North Austin Medical Center is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $573. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 5.49x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$573

Average discount available for prompt cash payment at this facility.

Insurance Median
$101

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: $573 (3116%)
Insurance Median: $101 (549%)
Cash: $573 (3116% of Medicare)
Ins. Median: $101 (549% 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 549% of the Medicare baseline (a markup of 449%). 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
Superior Health Plan $14 - $174 76%
St David’S Hospice $15 - $18 82%
Blue Cross Blue Shield $16 - $302 87%
United $16 - $461 87%
Molina Healthcare $17 - $20 92%
Aetna $18 - $19 98%
Cigna $18 - $52 98%
Devoted Health $18 98%
Humana $18 - $19 98%
Odyssey Hospice $18 98%
Triwest Healthcare Alliance $18 98%
UnitedHealthcare $18 - $461 98%
Wellmed $18 98%
American Health Plan Of Texas $19 103%
Provider Partners Health Plan $19 103%
Sendero $19 - $31 103%
Shared Health $19 103%
Texas Independent Health Plan $19 103%
Wellcare $19 103%
Imperial Insurance $20 109%
Pyramid Life $20 109%
Triwest Health Alliance $20 109%
Universal Health $22 120%
Austin Fc $23 125%
Amerigroup $25 136%
Naphcare $28 152%
Seven Corners $28 152%
Corvel Corporation $36 196%
Oscar $51 - $56 277%
Moda $64 - $241 348%
Covenant Management Systems $79 - $295 430%
Healthcare Highways $79 - $308 430%
Imo Med - Select Network $82 - $308 446%
Nomi Health $87 - $379 473%
Moda Health $98 - $379 533%
Evry Health $100 - $377 544%
Texas Healthcare Foundation Heb $101 - $379 549%
Texas Workforce Commission $106 - $400 576%
Harbor Health Team $109 - $410 593%
Averde Health $123 - $461 669%
Comanche County $136 - $512 740%
National Choicecare $136 - $512 740%
Healthsmart Preferred Care $150 - $820 816%
Independent Medical Systems $150 - $564 816%
Physicians Cooperative Of Texas $150 - $564 816%
Prime Health $164 - $615 892%
First Health $171 - $728 930%
Coastal Comp Health Networks $177 - $666 962%
National Health Care $177 - $666 962%
Texas Municipal League $191 - $718 1039%
Medcorp Southwest $205 - $769 1115%
Rockport Healthcare Group $218 - $922 1185%
Bce Emergis Corporation $246 - $922 1338%
Beech Street $246 - $922 1338%
Medical Control Network Solutions $246 - $922 1338%
Multiplan $246 - $922 1338%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals