CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Astria Sunnyside Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $230
Cash Discount Price: $184
vs. Medicare Baseline: 12.51x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Astria Sunnyside Hospital is $230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $184. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 12.51x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$184

Average discount available for prompt cash payment at this facility.

Insurance Median

$230

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: $184 (1001%)

Insurance Median: $230 (1251%)

Cash: $184 (1001% of Medicare)

Ins. Median: $230 (1251% 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 1251% of the Medicare baseline (a markup of 1151%). 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
Medicare (plans)	$17 - $19	92%
Aetna	$18 - $430	98%
Healthcomp_Ihs	$18	98%
Humana	$18 - $440	98%
Va	$18	98%
Tricare	$19	103%
Medicaid / KanCare	$64 - $150	348%
Molina	$64 - $120	348%
Regence	$134 - $251	729%
Cigna	$157 - $293	854%
Li	$160 - $300	870%
First_Choice	$196 - $367	1066%
Tpsc	$204 - $381	1109%
Kaiser	$205 - $384	1115%
Premera	$212 - $398	1153%
UnitedHealthcare	$222 - $416	1207%
Fhpw	$230 - $430	1251%
Healthcomp	$235 - $440	1278%
Bcchp	$261 - $489	1419%
Great_Rivers	$261 - $489	1419%
Zenith	$261 - $489	1419%

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 $184.
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 Astria Sunnyside 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.