CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Crouse Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $22
Cash Discount Price: $71
vs. Medicare Baseline: 1.20x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Crouse Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.20x the Medicare baseline. Located in 736 Irving Avenue, Syracuse, NY.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$22

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: $71 (386%)

Insurance Median: $22 (120%)

Cash: $71 (386% of Medicare)

Ins. Median: $22 (120% 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
Brighton Healthplan	$11 - $22	60%
Excellus	$11 - $40	60%
Fidelis	$11 - $33	60%
Healthfirst Health Plan	$11 - $12	60%
Molina	$11 - $24	60%
Mycompass	$11 - $23	60%
UnitedHealthcare	$11 - $37	60%
Wellcare	$11 - $24	60%
Aetna	$22 - $39	120%
Cdphp	$22	120%
Emblemhealth	$22	120%
Humana	$22	120%
Martins Point	$22	120%
Mvp	$22 - $47	120%
Nascentia	$22	120%
Emblem Health	$51	277%

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 $71.
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 Crouse 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.