CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Mt Ascutney Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $299
  • Cash Discount Price: $260
  • vs. Medicare Baseline: 16.26x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Mt Ascutney Hospital is $299. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $260. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 16.26x the Medicare baseline. Located in 289 County Road, Windsor, VT.
Cash / Self-Pay
$260

Average discount available for prompt cash payment at this facility.

Insurance Median
$299

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: $260 (1414%)
Insurance Median: $299 (1626%)
Cash: $260 (1414% of Medicare)
Ins. Median: $299 (1626% 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 1626% of the Medicare baseline (a markup of 1526%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $235 - $289 1278%
The Vermont Health Plan $236 1283%
Mvp Health Plan, Inc. $296 1610%
Cigna $302 1642%
Hphc Insurance Company, Inc. $302 1642%
Aetna $309 1680%
UnitedHealthcare $309 1680%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 289 County Road, Windsor, VT 05089
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals