CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Grace Cottage Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $155
Cash Discount Price: $141
vs. Medicare Baseline: 8.43x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Grace Cottage Hospital is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $141. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 8.43x the Medicare baseline. Located in Po Box 216, Townshend, VT.

Cash / Self-Pay

$141

Average discount available for prompt cash payment at this facility.

Insurance Median

$155

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: $141 (767%)

Insurance Median: $155 (843%)

Cash: $141 (767% of Medicare)

Ins. Median: $155 (843% 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 843% of the Medicare baseline (a markup of 743%). 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
Humana	$47 - $58	256%
Mvp Health Plan	$118 - $146	642%
UnitedHealthcare	$135 - $167	734%
Health Plans, Inc.	$141 - $175	767%
Cigna	$149 - $184	810%
Aetna	$152 - $188	827%
Blue Cross Blue Shield	$157 - $194	854%
Health New England	$157 - $194	854%

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 $141.
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 Grace Cottage 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.