CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Wilkes Regional Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $35
Cash Discount Price: $34
vs. Medicare Baseline: 1.90x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Wilkes Regional Medical Center is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.90x the Medicare baseline. Located in 1370 West D St, North Wilkesboro, NC.

Cash / Self-Pay

$34

Average discount available for prompt cash payment at this facility.

Insurance Median

$35

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: $34 (185%)

Insurance Median: $35 (190%)

Cash: $34 (185% of Medicare)

Ins. Median: $35 (190% 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.

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
Healthteam	$19	103%
Medcost	$20 - $49	109%
Aetna	$26 - $47	141%
Blue Cross Blue Shield	$26 - $40	141%
Ambetter / Centene	$32 - $41	174%
Amerihealth	$32 - $40	174%
Carolina Complete	$33	179%
Healthblue	$33	179%
Partners	$33	179%
Alliance	$34	185%
Trillium	$34	185%
UnitedHealthcare	$34 - $36	185%
Vaya	$34	185%
Wellcare	$34	185%
Cigna	$36 - $37	196%
Oscar	$37 - $44	201%
Directnet	$40	218%
Private Healthcare Systems	$61	332%
Multiplan	$63	343%

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 $34.
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 Wilkes Regional 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.