CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Unitypoint Health - Meriter

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $63
  • Cash Discount Price: $206
  • vs. Medicare Baseline: 3.43x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Unitypoint Health - Meriter is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $206. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 3.43x the Medicare baseline. Located in 202 S Park St, Madison, WI.
Cash / Self-Pay
$206

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $206 (1120%)
Insurance Median: $63 (343%)
Cash: $206 (1120% of Medicare)
Ins. Median: $63 (343% 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 343% of the Medicare baseline (a markup of 243%). 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
UnitedHealthcare $11 - $106 60%
Aspirus $18 - $155 98%
Blue Cross Blue Shield $18 - $245 98%
Humana $18 98%
Illinicare $18 98%
Meridiancare $18 98%
Prevea 360 $18 - $219 98%
Wellmark Uph Self-Funded $18 - $149 98%
Health Partners Open Network $29 - $94 158%
Cigna $48 - $77 261%
Security Health Plan $51 - $80 277%
Mercy Care $60 - $86 326%
Medical Associates Health Plan $63 - $93 343%
Quartz $80 435%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 202 S Park St, Madison, WI 53715
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals