CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Penn Presbyterian Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $181
  • Cash Discount Price: $599
  • vs. Medicare Baseline: 9.84x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Penn Presbyterian Medical Center is $181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $599. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 9.84x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$599

Average discount available for prompt cash payment at this facility.

Insurance Median
$181

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: $599 (3257%)
Insurance Median: $181 (984%)
Cash: $599 (3257% of Medicare)
Ins. Median: $181 (984% 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 984% of the Medicare baseline (a markup of 884%). 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
Cigna $11 - $368 60%
Blue Cross Blue Shield $18 - $1,162 98%
Medicare (plans) $18 - $19 98%
Philadelphia Va Medical Center $18 98%
Upmc $18 - $1,162 98%
Aetna $19 - $1,162 103%
Geisinger Health Plan $19 - $58 103%
Health Partners $19 - $1,162 103%
Humana $19 - $930 103%
Ibc $19 103%
Pa Health And Wellness $19 - $30 103%
Penn Life (Living Independently For Elders) $19 103%
UnitedHealthcare $19 - $1,162 103%
Clover Health Plan $20 109%
Keystone First $20 109%
Tricare $20 109%
Us Family Health Plan $20 109%
Gateway Health Plan $23 125%
Medicaid / KanCare $24 - $1,162 131%
Pa Medical Assistance $24 131%
Elap $26 141%
Claims Watcher $29 - $33 158%
Horizon Nj Health $29 - $204 158%
Ibc Commercial Hpn $30 163%
Keystone Hmo Proactive $30 163%
Keystone Mercy Health Plan $31 - $1,162 169%
Oscar Health Plan $31 169%
Centivo $33 179%
Elap Services $34 185%
Highmark $39 212%
Pgm - Regie De L'Assurance Maladie Quebec $40 - $267 218%
Preferred Health Care Eliance $43 - $290 234%
Penn Global Medicine $49 266%
Pgm - Kuwait Defense $61 - $523 332%
Devon $66 - $523 359%
Qualcare $66 - $442 359%
Coventry $69 - $593 375%
Pgm - Chop $69 - $465 375%
Wissahickon Hospice $69 - $465 375%
Healthamerica/Coventry $78 - $569 424%
Olympus $82 - $551 446%
First Health Global $86 - $581 468%
Urn-Cancer Resource Services $86 - $581 468%
Health Net $104 - $697 566%
Pgm - Royal Embassy Of Saudi Arabia $104 - $697 566%
Pgm - Embassy Of Qatar $112 - $755 609%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $112 - $755 609%
Pgm - Embassy Of The United Emirates/Ipc $121 - $813 658%
Devon Health Services Inc $138 - $930 750%
Health America/Ccn $138 - $930 750%
Intergroup $138 - $930 750%
Pgm - Kuwait Health Division $138 - $930 750%
Pgm - Kuwait Oil $138 - $930 750%
Preferred Care $138 - $930 750%
Commercial Other $173 - $1,162 941%
International Pfs $173 - $1,162 941%
Magellan $173 - $1,162 941%
Quest Behavioral Health $173 - $1,162 941%
United Behavioral Health $173 - $1,162 941%
Workers Compensation $173 - $1,162 941%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 51 North 39Th Street, Philadelphia, PA 19104
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals