CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Atrium Health Navicent Rehabilitation Hopsital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $63
Cash Discount Price: $83
vs. Medicare Baseline: 3.43x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Atrium Health Navicent Rehabilitation Hopsital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 3.43x the Medicare baseline. Located in 3351 Northside Dr, Macon, GA.

Cash / Self-Pay

$83

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

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: $83 (451%)

Insurance Median: $63 (343%)

Cash: $83 (451% of Medicare)

Ins. Median: $63 (343% 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 343% of the Medicare baseline (a markup of 243%). 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
UnitedHealthcare	$11 - $109	60%
Aetna	$18 - $116	98%
Alliant	$18 - $22	98%
Blue Cross Blue Shield	$18 - $23	98%
Georgia Health Advantage	$18	98%
Humana	$18 - $113	98%
Pruitt Health	$18	98%
Care Source	$19	103%
Clover	$19	103%
Eon Health	$19	103%
Cigna	$25 - $49	136%
Kaiser	$27 - $66	147%
Securehealth	$46 - $58	250%
Ambetter / Centene	$50 - $84	272%
Ibg	$81 - $117	440%
Multiplan	$107 - $132	582%
Novanet	$132	718%
Three Rivers Provider Network	$140	761%
Beechstreet	$153	832%

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 $83.
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 Atrium Health Navicent Rehabilitation Hopsital 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.