CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $175
Cash Discount Price: $288
vs. Medicare Baseline: 9.52x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $288. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 9.52x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$288

Average discount available for prompt cash payment at this facility.

Insurance Median

$175

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: $288 (1566%)

Insurance Median: $175 (952%)

Cash: $288 (1566% of Medicare)

Ins. Median: $175 (952% 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 952% of the Medicare baseline (a markup of 852%). 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	$18 - $270	98%
Managed Health Services	$18 - $20	98%
Molina Healthcare Of Wi	$18 - $258	98%
Network Health Plan	$18 - $253	98%
Quartz	$18 - $173	98%
Security Health Plan (Shp)	$18 - $175	98%
UnitedHealthcare	$18 - $64	98%
Veteran'S Administration (Va Ccn)	$18	98%
Blue Cross Blue Shield	$19 - $97	103%
Group Health Cooperative Of Eau Claire	$19 - $288	103%
My Choice	$19	103%
Trilogy	$19 - $273	103%
Icare	$20 - $21	109%
The Alliance	$154	837%
Amish/Mennonite	$167	908%
Wps Health Insurance	$204	1109%
Cigna	$206 - $224	1120%
Health Payment Systems	$211	1147%
First Health	$258	1403%
Healtheos By Multiplan Inc.	$282 - $288	1533%
Health Partners	$288	1566%
Coventry	$291	1582%

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 $288.
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 Marshfield Medical Center - Beaver Dam (Mmc-Bd) 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.