CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Lancaster General Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $43
  • Cash Discount Price: $133
  • vs. Medicare Baseline: 2.34x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Lancaster General Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $133. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 2.34x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$133

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $133 (723%)
Insurance Median: $43 (234%)
Cash: $133 (723% of Medicare)
Ins. Median: $43 (234% 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 234% of the Medicare baseline (a markup of 134%). 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
Tricare $15 82%
Albright Life $18 98%
Coatesville Va $18 98%
Highmark $18 - $133 98%
Hospice Generic $18 98%
Lebanon Veterans Hospital $18 98%
Medicare (plans) $18 - $20 98%
UnitedHealthcare $18 - $113 98%
Aetna $19 - $80 103%
Amerihealth Caritas $19 - $24 103%
Blue Cross Blue Shield $19 - $113 103%
Cigna $19 - $111 103%
Devoted Health $19 103%
Health Partners Mcr Advantage $19 103%
Pa Health And Wellness Mcr $19 103%
Lancaster County Mh $24 131%
Medicaid / KanCare $24 - $40 131%
Hospice And Community Care $25 136%
Elap Employees $26 141%
Gateway $28 152%
Old Order Group $36 - $43 196%
Oscar Health Plan $36 196%
Lg Coresource/Lg Eliance $38 207%
Lancashire Hall $40 - $133 218%
Nursing Home Op Services $40 218%
Upmc For You $41 223%
Highmark Commercial Preferred $42 - $133 228%
Affilia Home Health $53 - $133 288%
Claim Watcher Plus $55 299%
Masonic Homes $56 - $133 305%
Eliance Health Solutions $60 - $85 326%
Claim Watcher $61 332%
Highmark Commercial Non-Preferred $63 - $133 343%
Elap Other Groups $67 364%
Preferred Healthcare $80 - $113 435%
Ehp $109 593%
Upmc Commercial $109 - $113 593%
Devon $113 614%
Geisinger Commercial $113 614%
Intergroup Services $113 614%
Medi-Share Christian Care $126 685%
Commercial Generic $133 723%
Magellan $133 723%
United Behavioral Health $133 723%
Value Options $133 723%
Workers Compensation $133 723%
Gift Of Life Donor Program $13,500 73409%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals