CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Prosser Memorial Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $148
Cash Discount Price: $110
vs. Medicare Baseline: 8.05x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Prosser Memorial Hospital is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $110. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 8.05x the Medicare baseline. Located in 723 Memorial Street, Prosser, WA.

Cash / Self-Pay

$110

Average discount available for prompt cash payment at this facility.

Insurance Median

$148

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: $110 (598%)

Insurance Median: $148 (805%)

Cash: $110 (598% of Medicare)

Ins. Median: $148 (805% 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 805% of the Medicare baseline (a markup of 705%). 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	$31 - $92	169%
Kaiser Permanente	$37 - $207	201%
Community Health Plan Of Washington	$39 - $92	212%
Coordinated Care	$39 - $92	212%
Molina	$41 - $92	223%
Amerigroup	$42 - $97	228%
Health Alliance Northwest	$46 - $57	250%
Wellcare	$46 - $57	250%
Humana	$47 - $193	256%
Aetna	$56 - $193	305%
Ambetter / Centene	$130 - $175	707%
Asuris	$148 - $204	805%
Health Management Adminstrators	$148 - $204	805%
Premera	$148 - $182	805%
Regence	$148 - $204	805%
Cigna	$152 - $186	827%
First Choice	$157 - $193	854%
Multiplan	$157 - $204	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 $110.
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 Prosser Memorial 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.