CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Southern Ocean Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $217
Cash Discount Price: $18
vs. Medicare Baseline: 11.80x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Southern Ocean Medical Center is $217. 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 11.80x the Medicare baseline. Located in 1140 Rt 72 W, Manahawkin, NJ.

Cash / Self-Pay

$18

Average discount available for prompt cash payment at this facility.

Insurance Median

$217

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: $217 (1180%)

Cash: $18 (98% of Medicare)

Ins. Median: $217 (1180% 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 1180% of the Medicare baseline (a markup of 1080%). 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
Amerigroup	$18	98%
Clover	$18	98%
Seoul Medical Group	$18	98%
Vaccn	$18	98%
Wellcare	$18	98%
United Community/Americhoice	$19	103%
Aetna	$20 - $279	109%
UnitedHealthcare	$22 - $40	120%
Karna	$24	131%
Cigna	$84 - $262	457%
Oxford	$177	962%
Horizon	$208 - $300	1131%
Bergen Risk	$246	1338%
Brighton Health Plan	$262	1425%
Multiplan - PHCS	$279	1517%
Amerihealth	$285 - $323	1550%
Qualcare	$298	1620%

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 $18.
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 Southern Ocean 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.