CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Clarion Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $35
  • Cash Discount Price: $97
  • vs. Medicare Baseline: 1.90x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Clarion Hospital is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 1.90x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$97

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: $97 (527%)
Insurance Median: $35 (190%)
Cash: $97 (527% 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.

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
Martin'S Point - Usfhp $17 - $61 92%
Tricare $17 92%
Upmc $17 - $86 92%
Amerihealth $18 - $27 98%
Cigna $18 - $86 98%
Highmark $18 - $59 98%
Highmark Community Blue $18 98%
Medicare (plans) $18 98%
UnitedHealthcare $18 98%
Aetna $19 - $154 103%
Devoted Health Plan $19 - $69 103%
Geisinger $19 - $20 103%
The Health Plan $19 - $43 103%
American Health Plan $20 109%
Gateway $20 - $64 109%
Jefferson Health Plan $20 109%
Pa Health & Wellness $20 109%
Medicaid / KanCare $24 131%
Highmark - Ind.& Managed Care $41 - $59 223%
Peak Health $43 - $121 234%
Devon $130 707%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals