CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Charleston Area Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $190
Cash Discount Price: $234
vs. Medicare Baseline: 10.33x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Charleston Area Medical Center is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $234. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 10.33x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$234

Average discount available for prompt cash payment at this facility.

Insurance Median

$190

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: $234 (1272%)

Insurance Median: $190 (1033%)

Cash: $234 (1272% of Medicare)

Ins. Median: $190 (1033% 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 1033% of the Medicare baseline (a markup of 933%). 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
Aetna	$17 - $239	92%
The Health Plan Of West Virginia Inc.	$17 - $237	92%
Unicare Health Plan Of West Virginia Inc.	$17	92%
Blue Cross Blue Shield	$18 - $222	98%
Choicecare Network	$18 - $239	98%
Optimum Choice Inc.	$18	98%
Triwest Va	$18	98%
UnitedHealthcare	$19 - $239	103%
West Virginia Senior Advantage Inc.	$19	103%
Integrated Medical Solutions	$36	196%
Naphcare	$37	201%
Caresource	$46	250%
Tricare	$134 - $146	729%
City Of Charleston	$168 - $183	914%
Cigna	$208 - $227	1131%
Three Rivers Providers Network	$217 - $237	1180%
Healthsmart	$220 - $239	1196%
Multiplan	$220 - $239	1196%

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 $234.
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 Charleston Area Medical Center 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.