CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Mt Sinai Hospital Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $76
  • Cash Discount Price: $184
  • vs. Medicare Baseline: 4.13x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Mt Sinai Hospital Medical Center is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $184. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 4.13x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$184

Average discount available for prompt cash payment at this facility.

Insurance Median
$76

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: $184 (1001%)
Insurance Median: $76 (413%)
Cash: $184 (1001% of Medicare)
Ins. Median: $76 (413% 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 413% of the Medicare baseline (a markup of 313%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $16 - $877 87%
Blue Cross Blue Shield $16 - $247 87%
Family Health Network Mcaid - All Plans $16 87%
Cigna $17 - $480 92%
Molina Mcaid $17 92%
Advocate Physician Prtnrs Mcr $18 98%
Cenpatico Illinicare Dual $18 98%
Cenpatico Illinicare Mcr - All Other Plans $18 98%
Humana $18 - $1,218 98%
Lawndale Christian - All Plans $18 - $78 98%
Meridian/Harmony D-Snp - All Plans $18 98%
Nextlevel Hlth Icp Fhp Aca - All Plans $18 98%
Tricare $18 98%
UnitedHealthcare $18 98%
Va Healthnet - All Plans $18 98%
Harmony Behavioral Htlh - All Plans $19 103%
Molina Mcr - All Other Plans $19 103%
Zing Mcr Adv - All Plans $19 103%
Advocate Physician Prtnrs - All Other Plans $20 109%
Ambetter / Centene $20 - $407 109%
Partners In Hlth - All Plans $55 - $155 299%
Healthlink Hmo $69 - $194 375%
Healthlink Ppo - All Other Plans $69 - $194 375%
Oscar - All Plans $71 - $151 386%
Compsych Ip/Op Only - All Plans $82 - $233 446%
Hfn Platinum $89 - $252 484%
Multiplan Primary Ntwrk/Phcs - All Other Plans $96 - $272 522%
Hfn Epo $110 - $310 598%
Multiplan Complementary Ntwrk $110 - $310 598%
Hfn Ppo - All Other Plans $121 - $341 658%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals