CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Vandalia Health Broaddus Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $72
Cash Discount Price: $56
vs. Medicare Baseline: 3.92x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Vandalia Health Broaddus Hospital is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 3.92x the Medicare baseline. Located in 1 Healthcare Drive Mansfield Hill, Philippi, WV.

Cash / Self-Pay

$56

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

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: $56 (305%)

Insurance Median: $72 (392%)

Cash: $56 (305% of Medicare)

Ins. Median: $72 (392% 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 392% of the Medicare baseline (a markup of 292%). 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
Peak Health	$13 - $26	71%
Aetna	$17 - $73	92%
Blue Cross Blue Shield	$33 - $58	179%
Highmark	$56 - $60	305%
The Health Plan	$57 - $74	310%
UnitedHealthcare	$57 - $80	310%
Humana	$59 - $63	321%
West Virginia Senior Advantage	$60 - $64	326%
Cigna	$67 - $72	364%
First Health	$69 - $73	375%
Geisenger Health Plan	$72 - $76	392%
Health Network America	$72 - $78	392%
Multiplan/Phcs	$72 - $77	392%
Geha	$73 - $78	397%
Selectnet	$75 - $80	408%

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 $56.
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 Vandalia Health Broaddus 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.