CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Oakleaf Surgical Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $18
  • Cash Discount Price: $96
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Oakleaf Surgical Hospital is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 0.98x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$96

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $96 (522%)
Insurance Median: $18 (98%)
Cash: $96 (522% of Medicare)
Ins. Median: $18 (98% 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.

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
Blue Cross Blue Shield $18 98%
Dean Health Plan $18 98%
Group Health Cooperative Of Eau Claire $18 98%
Healthpartners $18 98%
Humana $18 98%
Medica $18 98%
Quartz Health Solutions $18 98%
Security Health Plan Of Wi $18 98%
Ucare Wi $18 98%
UnitedHealthcare $18 98%

Consumer Guidance & Cost Commentary

Oakleaf Surgical Hospital, located at 1000 Oakleaf Way in Altoona, Wisconsin, reported a cash median price of $96 for the CPT code 84153 (Blood test, PSA). This cash rate is significantly lower than the facility's gross charge of $106 and the Medicare benchmark amount of $18.39. While the facility's ownership is classified as Physician-owned, the data indicates a median negotiated rate of $18 and a median paid rate of $84 across ten payers. Notably, every payer listed in the dataset, including Blue Cross Blue Shield, UnitedHealthcare, and Humana, applies a uniform allowed amount of $18.

For patients with high-deductible plans, the cash price of $96 may be more affordable than the insurance negotiated rate of $18 if the plan's deductible has not yet been met, as commercial rates often exceed cash prices due to administrative overhead. Patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts to further reduce the $96 cash median. It is important to request a full itemized bill before payment to avoid summary bills that obscure individual costs, and to ensure no services were billed for that were not rendered. Since the Medicare amount is substantially lower than both the cash and negotiated rates, comparing the final charge to the Medicare benchmark of $18.39 provides the most accurate view of the facility's cost structure relative to federal standards.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Oakleaf Way, Altoona, WI 54720
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals