CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: The University of Vermont Health Network-Alice Hy

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $21
Cash Discount Price: $49
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at The University of Vermont Health Network-Alice Hy is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.14x the Medicare baseline. Located in 133 Park Street, Po Box 729, Malone, NY.

Cash / Self-Pay

$49

Average discount available for prompt cash payment at this facility.

Insurance Median

$21

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: $49 (266%)

Insurance Median: $21 (114%)

Cash: $49 (266% of Medicare)

Ins. Median: $21 (114% 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
Aetna	$7 - $74	38%
Blue Cross Blue Shield	$7 - $28	38%
Capital District Physicians' Health Plan	$7 - $81	38%
Choicecare	$7 - $64	38%
Fidelis Care	$7 - $28	38%
Humana	$7 - $28	38%
Martins Point	$7 - $28	38%
Mvp	$7 - $71	38%
St. Regis	$7 - $28	38%
UnitedHealthcare	$7 - $85	38%
Veterans Affairs Community Care Network	$7 - $28	38%
Magnacare	$18 - $69	98%
Highmark Blueshield	$21 - $77	114%

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 $49.
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 The University of Vermont Health Network-Alice Hy 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.