CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: UPMC Altoona

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $35
Cash Discount Price: $119
vs. Medicare Baseline: 1.90x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at UPMC Altoona is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.90x the Medicare baseline. Located in 620 Howard Avenue, Altoona, PA.

Cash / Self-Pay

$119

Average discount available for prompt cash payment at this facility.

Insurance Median

$35

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: $119 (647%)

Insurance Median: $35 (190%)

Cash: $119 (647% of Medicare)

Ins. Median: $35 (190% 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
Upmc Work Partners	$18	98%
Upmc Health Plan	$19 - $103	103%
Amerihealth Caritas	$20 - $38	109%
Cigna	$20 - $99	109%
Highmark Wholecare (Prev Gateway)	$20 - $36	109%
Pa Health & Wellness	$20 - $42	109%
UnitedHealthcare	$20 - $101	109%
Aetna	$24 - $105	131%
Cbhnp	$24	131%
Health Partners Plans (Jefferson Health Plan)	$24	131%
Geisinger	$34 - $109	185%
Blue Cross Blue Shield	$36	196%
Preferred Healthcare System	$99	538%
Private Health Care Systems	$158	859%

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 $119.
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 UPMC Altoona 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.