CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Carolina East Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $87
Cash Discount Price: $67
vs. Medicare Baseline: 4.73x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Carolina East Medical Center is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $67. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 4.73x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$67

Average discount available for prompt cash payment at this facility.

Insurance Median

$87

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: $67 (364%)

Insurance Median: $87 (473%)

Cash: $67 (364% of Medicare)

Ins. Median: $87 (473% 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 473% of the Medicare baseline (a markup of 373%). 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
Humana	$18	98%
Inclusive Health (Nchirp)-All Plans	$18	98%
Tricare	$18 - $178	98%
Pamlico Co Jail-All Plans	$26 - $47	141%
UnitedHealthcare	$34 - $127	185%
Craven Co. Jail Systems - All Plans	$38 - $60	207%
Medcost Ppo Employees And Retirees	$64 - $117	348%
Medcost Ppo Ultra (Employees)	$64 - $111	348%
Blue Cross Blue Shield	$68 - $122	370%
Medcost Ppo City Employees	$71 - $130	386%
Medcost Ppo County Employee	$74 - $135	402%
Benefit Mgmt, Svcs-All Plans	$83 - $151	451%
Aetna	$87 - $158	473%
Medcost Benefit Svc-All Other Plans	$87 - $157	473%
Acs Consult Svc Inc-All Plans	$89 - $161	484%
Cigna	$89 - $162	484%
Medcost Ppo Standard	$89 - $161	484%

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 $67.
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 Carolina East 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.