CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Novant Health Presbyterian Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $57
Cash Discount Price: $49
vs. Medicare Baseline: 3.10x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Novant Health Presbyterian Medical Center is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 3.10x the Medicare baseline. Located in 200 Hawthorne Lane Box 33549, Charlotte, NC.

Cash / Self-Pay

$49

Average discount available for prompt cash payment at this facility.

Insurance Median

$57

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: $49 (266%)

Insurance Median: $57 (310%)

Cash: $49 (266% of Medicare)

Ins. Median: $57 (310% 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 310% of the Medicare baseline (a markup of 210%). 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	$12 - $48	65%
Blue Cross Blue Shield	$12 - $196	65%
Carolina Complete	$12 - $47	65%
Nc Department Of Public Safety	$12 - $47	65%
UnitedHealthcare	$12 - $159	65%
Wellcare	$12 - $48	65%
Humana	$18 - $196	98%
Pace Of The Southern Piedmont	$18	98%
Aetna	$19 - $218	103%
Cigna	$19 - $140	103%
Liberty Health	$19	103%
Caresource North Carolina	$23 - $90	125%
Atlantic Corporation Dba Atlantic Packaging	$32 - $125	174%
Amps	$38 - $150	207%
Plotkin Health	$42 - $163	228%
Medcost	$50 - $204	272%
Multiplan	$52 - $204	283%
Phcs	$52 - $204	283%
Primary Physician Care	$52 - $201	283%
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 $49.
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 Presbyterian 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.