CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: UPMC Carlisle

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $57
  • Cash Discount Price: $110
  • vs. Medicare Baseline: 3.10x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at UPMC Carlisle is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $110. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 3.10x the Medicare baseline. Located in 361 Alexander Spring Road, Carlisle, PA.
Cash / Self-Pay
$110

Average discount available for prompt cash payment at this facility.

Insurance Median
$57

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: $110 (598%)
Insurance Median: $57 (310%)
Cash: $110 (598% of Medicare)
Ins. Median: $57 (310% 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 310% of the Medicare baseline (a markup of 210%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $18 - $100 98%
Humana $18 98%
Aetna $19 - $89 103%
Cigna $19 - $48 103%
Geisinger $19 - $132 103%
Upmc Work Partners $19 103%
Pa Health & Wellness $20 - $42 109%
UnitedHealthcare $20 - $32 109%
Amerihealth Caritas $24 131%
Prime Net $25 - $138 136%
Keystone Autism Services $29 158%
Highmark Wholecare (Prev Gateway) $31 169%
Upmc Health Plan $32 - $128 174%
Health Partners Plans (Jefferson Health Plan) $33 179%
Keystone Health Plan $37 - $100 201%
Wellspan Population Health $119 - $146 647%
Multiplan $156 848%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 361 Alexander Spring Road, Carlisle, PA 17015
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals