CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Saint Michael's Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $19
  • Cash Discount Price: $18
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Saint Michael's Medical Center is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.03x the Medicare baseline. Located in 111 Central Avenue, Newark, NJ.
Cash / Self-Pay
$18

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

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: $18 (98%)
Insurance Median: $19 (103%)
Cash: $18 (98% of Medicare)
Ins. Median: $19 (103% 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.

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
UnitedHealthcare $11 - $18 60%
Tricare $15 82%
Aetna $18 - $39 98%
Amerihealth $18 98%
Horizon $18 - $77 98%
Humana $18 98%
Medicare (plans) $18 98%
New Jersey Out of State $18 98%
Wellpoint Amerigroup $18 98%
Clover Health $19 103%
Curana $19 103%
Wellcare $19 - $25 103%
Fairprice Healthcare Holdings - Fphh $22 120%
Employer Direct Healthcare $26 141%
Cigna $27 147%
Naphcare $28 152%
Coventry $37 201%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 111 Central Avenue, Newark, NJ 07102
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals