CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Medstar Health Physical Therapy

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $143
Cash Discount Price: $143
vs. Medicare Baseline: 7.78x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Medstar Health Physical Therapy is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $143. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 7.78x the Medicare baseline. Located in 102 Irving St Nw, Washington, DC.

Cash / Self-Pay

$143

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $143 (778%)

Insurance Median: $143 (778%)

Cash: $143 (778% of Medicare)

Ins. Median: $143 (778% 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 778% of the Medicare baseline (a markup of 678%). 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
Carefirst Advantage Inc	$18	98%
Tricare	$18	98%
UnitedHealthcare	$18 - $176	98%
Aetna	$19 - $154	103%
Health Care Service Corporation	$19	103%
Humana	$19	103%
Kaiser Permanente	$19 - $154	103%
Carefirst Blue Choice Inc	$108 - $141	587%
Jhhc	$143	778%
Pfc	$143	778%
Medstar Family Choice Inc	$156	848%
Kaiser	$172	935%
Cigna	$187	1017%
First Health	$187	1017%
Private Healthcare Systems (Phcs)	$187	1017%

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 $143.
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 Medstar Health Physical Therapy 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.