CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Cambridge Health Alliance

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $55
  • Cash Discount Price: $55
  • vs. Medicare Baseline: 2.99x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Cambridge Health Alliance is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 2.99x the Medicare baseline. Located in 1493 Cambridge Street, Cambridge, MA.
Cash / Self-Pay
$55

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $55 (299%)
Insurance Median: $55 (299%)
Cash: $55 (299% of Medicare)
Ins. Median: $55 (299% 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 299% of the Medicare baseline (a markup of 199%). 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
Boston Medical Center - Wellsense [50003] $16 - $17 87%
Fallon [50006] $16 - $17 87%
Mass General Brigham [50021] $16 - $35 87%
Mass Health [70001] $16 - $17 87%
Medicaid / KanCare $16 - $17 87%
Other Tufts Health Public Plan [75002] $16 - $30 87%
Tufts Together W Cha [75001] $16 - $17 87%
UnitedHealthcare $16 - $59 87%
Mass Bh Partnership [70098] $17 92%
Medicare (plans) $18 - $55 98%
Aarp [40001] $25 136%
Oxford Health [40004] $25 136%
United Medical Resource [40005] $25 136%
Wc [90001] $26 141%
Blue Cross Blue Shield $36 - $55 196%
Multiplan [50010] $37 201%
Wellpoint [50012] $37 201%
Aetna $49 - $55 266%
Cigna $53 - $127 288%
Tufts Health Plan [30001] $53 - $60 288%
Altus Dental [99011] $55 299%
Beacon Health Strategies [50002] $55 299%
Cbhc Uninsured Crisis Alt Payer [70097] $55 299%
Cbhc Uninsured Crisis [70096] $55 299%
Celticare [50004] $55 299%
Commonwealth Care Alliance Dental [99004] $55 299%
Coverage Discovery [90004] $55 299%
Delta Dental Of Ma [99007] $55 299%
Dominion National Dental [99012] $55 299%
Dph Tb Payor [85004] $55 299%
Esp Dental [99003] $55 299%
Eyemed Alt Payor [13001] $55 299%
First Health [50007] $55 299%
Global Medical Management [50024] $55 299%
Government Employee Health Association [50023] $55 299%
Guardian Dental [99013] $55 299%
Health Safety Net Dental [99002] $55 299%
Humana $55 299%
Ma Laborers Health And Welfare Fund [50022] $55 299%
Magellan Health Services [65098] $55 299%
Mass Health Dental [99001] $55 299%
Medical Mutual Of Ohio [50019] $55 299%
Metlife Dental [99008] $55 299%
Modern Assistance Program [30098] $55 299%
Mva [90002] $55 299%
Neighborhood Health Plan [50011] $55 299%
Other Bh Payor [50014] $55 299%
Other Commercial Payor [50015] $55 299%
Other Dental Payor [99014] $55 299%
Other Dual Eligible Payer [65004] $55 299%
Other Gov'T Alt [85006] $55 299%
Other Vision Payor [50013] $55 299%
Ri Neighborhood Health Plan [50017] $55 299%
Tricare $55 299%
Health Plans Inc [20002] $59 321%
Hphc [20001] $59 321%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1493 Cambridge Street, Cambridge, MA 02139
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals