CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Penn State Health St. Joseph

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $51
Cash Discount Price: $32
vs. Medicare Baseline: 2.77x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Penn State Health St. Joseph is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 2.77x the Medicare baseline. Located in 2500 Bernville Road, Reading, PA.

Cash / Self-Pay

$32

Average discount available for prompt cash payment at this facility.

Insurance Median

$51

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: $32 (174%)

Insurance Median: $51 (277%)

Cash: $32 (174% of Medicare)

Ins. Median: $51 (277% 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 277% of the Medicare baseline (a markup of 177%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
[Amerihealth Caritas]	$16 - $18	87%
[Highmark Wholecare]	$16 - $18	87%
[Geisinger]	$17 - $91	92%
[Health Partners Plans]	$17 - $19	92%
[Pa Health & Wellness]	$17 - $19	92%
UnitedHealthcare	$18 - $85	98%
[Cbc]	$18 - $67	98%
[Highmark]	$18 - $69	98%
[Ibc]	$18 - $63	98%
Aetna	$19 - $64	103%
Humana	$19	103%
[Healthspring]	$19	103%
[Upmc]	$19 - $93	103%
[Point Comfort Underwriters]	$23	125%
Cigna	$53 - $77	288%
[Highmark Choice Blue]	$56	305%
[Highmark Aca]	$58	315%
[Preferred Healthcare Systems]	$90 - $94	489%
[First Health]	$96 - $101	522%
[Multiplan]	$96 - $101	522%

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 $32.
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 Penn State Health St. Joseph 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.