CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Ascension Seton Southwest

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $19
Cash Discount Price: $89
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Ascension Seton Southwest is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.03x the Medicare baseline. Located in 7900 Fm 1826, Austin, TX.

Cash / Self-Pay

$89

Average discount available for prompt cash payment at this facility.

Insurance Median

$19

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: $89 (484%)

Insurance Median: $19 (103%)

Cash: $89 (484% of Medicare)

Ins. Median: $19 (103% 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.

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
Ambetter / Centene	$15 - $33	82%
Blue Cross Blue Shield	$15 - $87	82%
Dell Chip/Chip Perinate	$15 - $19	82%
Dell Star	$15 - $21	82%
UnitedHealthcare	$15 - $21	82%
Wellpoint Chip/Chip Perinate	$15 - $19	82%
Wellpoint Star	$15 - $19	82%
Wellpoint Star Kids	$15	82%
Wellpoint Star Plus	$15 - $19	82%
Aarp Mc Wellmed	$18	98%
Addr Cancer Together	$18	98%
Aetna	$18 - $137	98%
Covid Hrsa	$18	98%
Cshcn Cidc	$18	98%
Devoted Health Mcr Replacement	$18	98%
Humana	$18 - $30	98%
Medicare (plans)	$18	98%
Research Study	$18	98%
Sendero Chap	$18	98%
Smarthealth	$18	98%
Superior Allwell	$18	98%
Tricare	$18	98%
Wellcare Med Advantage	$18	98%
Connected Senior Care	$19	103%
Pphp Mcr Advantage	$19	103%
Tx Independence Hp	$19	103%
Champva	$22 - $25	120%
Occunet	$26	141%
Sendero Idealcare	$32	174%
Cigna	$43	234%
Seton Performance Plus	$45	245%
Superior Star	$99	538%
Superior Star Foster	$99	538%
Superior Star Kids	$99	538%
Superior Star Plus	$99	538%
Covenant Health	$100	544%
Superior Chip/Chip Perinate	$112	609%

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 $89.
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 Ascension Seton Southwest 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.