CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: North Shore Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $22
  • Cash Discount Price: $596
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at North Shore Medical Center is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $596. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.20x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
$596

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $596 (3241%)
Insurance Median: $22 (120%)
Cash: $596 (3241% of Medicare)
Ins. Median: $22 (120% 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
Humana $6 - $238 33%
Medicaid / KanCare $6 - $596 33%
UnitedHealthcare $6 - $18 33%
Cigna $9 - $298 49%
Veterans Administration Mill Bill $13 71%
Avmed Broad Network $16 87%
Medicare (plans) $16 - $596 87%
Aetna $18 - $429 98%
Devoted Health $18 98%
Employer Direct Healthcare $18 - $23 98%
Hospice Other $18 98%
Leon Health Inc $18 98%
Tricare $18 98%
Veterans Administration Vaccn $18 98%
Healthsun Health Plans $19 103%
Longevity Health Plan $19 103%
Dimension Health Wc $21 114%
Workers Compensation $21 114%
Bright Health Management Commercial $22 120%
Florida Pace Centers $22 120%
Imagine Health $22 120%
Oscar Health Plan Hix $22 120%
Centurion Prison $23 125%
Self Pay/Uninsured $23 125%
Avmed Exchange $32 174%
Ambetter / Centene $34 185%
Molina Marketplace Program Exchange $35 190%
Auto Insurance $37 201%
Avmed Select Network $37 201%
Amerihealth Caritas Next Exchange $40 218%
Bc/Bs Myblue Hmo Hix $74 402%
Bc/Bs Of Fl Network Blue $79 430%
Bc/Bs Of Fl Ppo $79 430%
Bc/Bs Of Fl Simplyblue $79 430%
Bc/Bs Of Fl Blue Select Exchange Non Par $86 468%
Bc/Bs Of Fl Health Options Hmo $86 468%
Bc/Bs Of Fl Phs $309 1680%
Magellan Behavioral Health $358 1947%
Dimensions International $388 2110%
First Health $405 2202%
Dimension Health Ppo $447 2431%
Beacon Health Strategies Commercial $596 3241%
Commercial Non-Contracted $596 3241%
Self Pay - Mcd Pending 100 Percent $596 3241%
Single Case Agreement $596 3241%
United Behavioral Health Psych $596 3241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals