CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Baylor Scott & White Medical Center Pflugerville

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $109
Cash Discount Price: $157
vs. Medicare Baseline: 5.93x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Baylor Scott & White Medical Center Pflugerville is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $157. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 5.93x the Medicare baseline. Located in 2600 East Pflugerville Parkway, Pflugerville, TX.

Cash / Self-Pay

$157

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $157 (854%)

Insurance Median: $109 (593%)

Cash: $157 (854% of Medicare)

Ins. Median: $109 (593% 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 593% of the Medicare baseline (a markup of 493%). 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	$11 - $21	60%
Baylor Scott & White Health Plan	$17 - $112	92%
Humana	$18 - $183	98%
Superior Health Plan	$18 - $47	98%
Triwest	$18	98%
American Health Plan	$19	103%
Corvel	$19	103%
Healthspring	$19	103%
Prime Health Services	$19	103%
Procare Advantage	$19	103%
Sedgwick	$27	147%
Blue Cross Blue Shield	$89 - $109	484%
Cigna	$124 - $145	674%
Aetna	$144	783%
Midcoast	$144	783%
Quiktrip	$144	783%
University Of Mary Hardin-Baylor	$152	827%
Independent Medical System	$157	854%
Curative	$170	924%
First Health	$183	995%
Healthsmart	$183 - $197	995%
Private Health Care System	$197	1071%
Three Rivers	$236	1283%

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 $157.
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 Pflugerville 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.