CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Novant Health Forsyth Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $68
Cash Discount Price: $80
vs. Medicare Baseline: 3.70x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Novant Health Forsyth Medical Center is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 3.70x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$68

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: $80 (435%)

Insurance Median: $68 (370%)

Cash: $80 (435% of Medicare)

Ins. Median: $68 (370% 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 370% of the Medicare baseline (a markup of 270%). 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
Amerihealth	$13 - $52	71%
Blue Cross Blue Shield	$13 - $196	71%
Carolina Complete	$13 - $51	71%
Nc Department Of Public Safety	$13 - $51	71%
UnitedHealthcare	$13 - $183	71%
Wellcare	$13 - $52	71%
Humana	$18 - $212	98%
Pace Of The Southern Piedmont	$18	98%
Aetna	$19 - $218	103%
Cigna	$19 - $162	103%
Liberty Health	$19	103%
Caresource North Carolina	$28 - $109	152%
Atlantic Corporation Dba Atlantic Packaging	$40 - $154	218%
Plotkin Health	$42 - $163	228%
Amps	$46 - $177	250%
Medcost	$60 - $256	326%
Primary Physician Care	$62 - $239	337%
Beechstreet	$63 - $245	343%
Multiplan	$63 - $245	343%
Phcs	$63 - $245	343%
Employers Choice Network	$68 - $264	370%
Three Rivers Provider Network	$68 - $264	370%

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 $80.
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 Novant Health Forsyth Medical Center 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.