CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Nemours Children's Hospital, Delaware

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $12
Cash Discount Price: $20
vs. Medicare Baseline: 0.65x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Nemours Children's Hospital, Delaware is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 0.65x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.

Cash / Self-Pay

$20

Average discount available for prompt cash payment at this facility.

Insurance Median

$12

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: $20 (109%)

Insurance Median: $12 (65%)

Cash: $20 (109% of Medicare)

Ins. Median: $12 (65% 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.

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
Keystone First Hlth Plan	$4 - $9	22%
Blue Cross Blue Shield	$7 - $18	38%
Celtic Transplant For De First Health	$7	38%
UnitedHealthcare	$7 - $12	38%
Wellpoint Maryland	$7	38%
Aetna	$8 - $12	44%
Fidelis	$8	44%
Health Partners	$8	44%
Kidz Partners	$8	44%
Upmc	$8	44%
Priority Partners John Hopkins	$10 - $18	54%
Six Degrees Health Transplant	$10	54%
Ambetter / Centene	$11	60%
Amerihealth Caritas Delaware	$11	60%
Cigna	$11 - $13	60%
Great West-One Health Plan	$11 - $13	60%
Geisinger Health Plan	$12	65%
Integra Administrative Group	$12	65%
National Transplant Network (Ntn)	$13	71%
Six Degrees Health	$13	71%
Star Healthcare Network	$13	71%
Life Trac Solid Organ And Bmt Transplant	$14	76%
Carefirst Md Community Health Plan	$18	98%
First Health Network	$19	103%
Insurance Administrators Of America	$19	103%
Interlink Transplant Network	$19	103%
Multiplan	$19	103%
Preferred Healthcare	$19	103%
Private Healthcare Systems	$19	103%
Three Rivers Provider Network	$19	103%
Celtic Transplant	$20 - $32	109%
Us Family Health Plan	$22	120%

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 $20.
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 Nemours Children's Hospital, Delaware 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.