CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Beloit Health System

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $155
Cash Discount Price: $73
vs. Medicare Baseline: 8.43x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Beloit Health System is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 8.43x the Medicare baseline. Located in 1969 W Hart Rd, Beloit, WI.

Cash / Self-Pay

$73

Average discount available for prompt cash payment at this facility.

Insurance Median

$155

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: $73 (397%)

Insurance Median: $155 (843%)

Cash: $73 (397% of Medicare)

Ins. Median: $155 (843% 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 843% of the Medicare baseline (a markup of 743%). 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
Aetna	$19 - $301	103%
Blue Cross Blue Shield	$19 - $168	103%
Cook Children'S Health Plan (Cchp)	$19 - $159	103%
Dean Health	$19 - $178	103%
Humana	$19 - $71	103%
Independent Care Health Plan	$19	103%
Managed Health Services	$19	103%
Molina Healthcare	$19	103%
Quartz	$19 - $206	103%
UnitedHealthcare	$19 - $238	103%
Wellcare	$19	103%
Naphcare	$29	158%
The Alliance	$76	413%
Wps	$84 - $235	457%
Wea Trust	$102 - $174	555%
Multiplan	$149 - $254	810%
Health Eos	$166 - $289	903%
Cigna	$171 - $301	930%
Hfn	$171 - $301	930%
Preferred Network Access	$171 - $301	930%

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 $73.
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 Beloit Health System 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.