CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Atrium Health Cleveland

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $90
  • Cash Discount Price: $104
  • vs. Medicare Baseline: 4.89x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Atrium Health Cleveland is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 4.89x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.
Cash / Self-Pay
$104

Average discount available for prompt cash payment at this facility.

Insurance Median
$90

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: $104 (566%)
Insurance Median: $90 (489%)
Cash: $104 (566% of Medicare)
Ins. Median: $90 (489% 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 489% of the Medicare baseline (a markup of 389%). 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 $19 - $160 103%
Cigna $19 - $166 103%
Humana $19 103%
UnitedHealthcare $19 - $111 103%
Alliance $23 - $35 125%
Amerihealth Caritas $23 - $29 125%
Blue Cross Blue Shield $23 - $85 125%
Carolina Complete Health $23 - $30 125%
Healthy Blue $23 - $30 125%
Partners $23 - $29 125%
Trillium $23 - $31 125%
Vaya $23 - $30 125%
Wellcare $23 - $30 125%
Medcost $41 - $138 223%
Ambetter / Centene $66 - $75 359%
Employers Health Network $92 - $110 500%
Physician Reach Out $104 566%
Magellan $125 680%
Gmmi $135 734%
Quik Trip $135 734%
Carolina Behavioral Health $150 - $166 816%
Healthgram $166 903%
Choicecare $170 924%
First Health $177 962%
Lifesynch Community Choice Care $177 962%
Private Health Care Systems $187 1017%
Beechstreet $191 1039%
Multiplan $197 1071%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 E Grover St, Shelby, NC 28150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals