CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Lee County Community Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $30
  • Cash Discount Price: $32
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Lee County Community Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.63x the Medicare baseline. Located in 127 Health Care Drive, Pennington Gap, VA.
Cash / Self-Pay
$32

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $32 (174%)
Insurance Median: $30 (163%)
Cash: $32 (174% of Medicare)
Ins. Median: $30 (163% 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
Blue Cross Blue Shield $18 - $138 98%
Optima Health $18 98%
UnitedHealthcare $18 - $30 98%
Aetna $19 - $138 103%
Molina Healthcare $19 - $32 103%
Ambetter / Centene $30 163%
Amerigroup $30 - $138 163%
Managed Medicaire $30 163%
Medicare (plans) $30 163%
Mountain Empire Pace $30 163%
Sentara Health $30 - $36 163%
United Mine Workers Of America $30 163%
Humana $31 169%
Cigna $32 - $138 174%
Devoted Health Plan $32 174%
Nhc Advantage $32 174%
Seven Corners, Inc. $73 397%
First Health Coventry $138 750%
Medcost $138 750%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 127 Health Care Drive, Pennington Gap, VA 24277
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals