CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: UPMC Muncy

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $178
Cash Discount Price: $208
vs. Medicare Baseline: 9.68x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at UPMC Muncy is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $208. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 9.68x the Medicare baseline. Located in 215 East Water Street, Muncy, PA.

Cash / Self-Pay

$208

Average discount available for prompt cash payment at this facility.

Insurance Median

$178

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: $208 (1131%)

Insurance Median: $178 (968%)

Cash: $208 (1131% of Medicare)

Ins. Median: $178 (968% 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 968% of the Medicare baseline (a markup of 868%). 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
Upmc Work Partners	$18	98%
Three Rivers Provider Network	$19 - $312	103%
Amerihealth Caritas	$27 - $2,208	147%
Geisinger	$27 - $232	147%
Highmark Wholecare (Prev Gateway)	$27 - $52	147%
Upmc Health Plan	$27 - $151	147%
UnitedHealthcare	$31 - $237	169%
Pa Health & Wellness	$42 - $2,316	228%
Cigna	$55 - $238	299%
Aetna	$106 - $229	576%
Coventry/First Health	$131 - $234	712%
Blue Cross Blue Shield	$136 - $160	740%
Wirerope Works	$193	1049%
Multiplan	$271 - $330	1474%
America'S Choice	$278	1512%
Intergroup	$278	1512%

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 $208.
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 Muncy 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.