CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Froedtert Community Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $90
Cash Discount Price: $85
vs. Medicare Baseline: 4.89x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Froedtert Community Hospital is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 4.89x the Medicare baseline. Located in 4805 S Moorland Rd, New Berlin, WI.

Cash / Self-Pay

$85

Average discount available for prompt cash payment at this facility.

Insurance Median

$90

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: $85 (462%)

Insurance Median: $90 (489%)

Cash: $85 (462% of Medicare)

Ins. Median: $90 (489% 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 489% of the Medicare baseline (a markup of 389%). 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
Blue Cross Blue Shield	$18 - $37	98%
Care Wisconsin	$18	98%
Community Care	$18	98%
Health Partners	$18 - $104	98%
Humana	$18	98%
Icare	$18	98%
Molina	$18	98%
Network Health Plan	$18 - $22	98%
Security Health Plan Secure Savers	$18	98%
UnitedHealthcare	$18 - $22	98%
Chorus Community Health Plan	$59 - $64	321%
Medical College Of Wisconsin	$59 - $64	321%
Centivo	$64 - $80	348%
Cigna	$87 - $94	473%
Common Ground	$89 - $96	484%
Sheboygan Employers Health Network	$89 - $96	484%
Wisconsin Physician Services	$89 - $96	484%
Health Payment Systems	$90 - $98	489%
Trilogy	$96 - $104	522%
Americas Choice	$129 - $139	701%
Healtheos	$129 - $139	701%
Multiplan/Private Healthcare Systems	$129 - $139	701%
First Health Network	$130 - $141	707%

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 $85.
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 Froedtert Community 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.