CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Wakemed, Cary Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $37
Cash Discount Price: $42
vs. Medicare Baseline: 2.01x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Wakemed, Cary Hospital is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 2.01x the Medicare baseline. Located in 1900 Kildare Farm Road, Cary, NC.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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: $42 (228%)

Insurance Median: $37 (201%)

Cash: $42 (228% of Medicare)

Ins. Median: $37 (201% 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 201% of the Medicare baseline (a markup of 101%). 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	$8 - $23	44%
Carolina Complete	$8 - $23	44%
Healthy Blue	$8 - $23	44%
Wellcare	$8 - $23	44%
First Health	$10 - $109	54%
Blue Cross Blue Shield	$13 - $62	71%
Cigna	$13 - $63	71%
Aetna	$16 - $84	87%
Cary - Alignment	$19	103%
Ambetter / Centene	$21 - $47	114%
Cary - Liberty	$22	120%
Cary - Pruitt	$22	120%
Cary - Wellcare	$22	120%
Medcost	$40 - $93	218%
Phcs	$45 - $99	245%
Multiplan	$50 - $112	272%

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 $42.
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 Wakemed, Cary Hospital 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.