CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Lone Peak Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $19
Cash Discount Price: $92
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Lone Peak Hospital is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.03x the Medicare baseline. Located in 11925 South State Street, Draper, UT.

Cash / Self-Pay

$92

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: $92 (500%)

Insurance Median: $19 (103%)

Cash: $92 (500% 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
Molina Healthcare	$16 - $18	87%
Cigna	$17 - $22	92%
Coventry Altius	$18	98%
Health Choice	$18	98%
Humana	$18	98%
Regence	$18 - $20	98%
Triwest Healthcare Alliance	$18	98%
University Of Ut	$18	98%
Veteran'S Administration	$18	98%
Blue Cross Blue Shield	$19	103%
Bright Health	$37	201%
Pehp	$59 - $74	321%
Aetna	$90 - $149	489%

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 $92.
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 Lone Peak Hospital 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.