84152

Psa (prostate specific antigen) measurement, complexed

Medicare pricing data for 194 providers across 19 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Psa (prostate specific antigen) measurement, complexed (HCPCS code 84152) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $17.95, but hospitals typically charge $84.55 — a 4.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.59

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $17.95, your out-of-pocket cost would be approximately $3.59. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$17.95
Average Hospital Charge
$84.55
Markup Ratio
4.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$84.55
Medicare Allowed$17.95
Medicare Payment$17.95

Hospitals charge 4.7x more than what Medicare allows for this procedure. Medicare actually pays $17.95 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$18$727468+0.4%
Illinois$18$93364+0.4%
Kansas$18$131116+0.4%
Massachusetts$18$531101+0.4%
New Jersey$18$1472396+0.4%
New York$18$84279+0.4%
North Carolina$18$137131,329+0.4%
Ohio$18$1413349+0.4%
Rhode Island$18$120114+0.4%
Washington$18$146333+0.4%
Puerto Rico$18$20924+0.4%
Arizona$18$1312121+0.4%
Colorado$18$142332+0.4%
Michigan$18$383410+0.3%
Texas$18$6393,410+0.2%
Alabama$18$872347-0.5%
Tennessee$18$5715153-0.8%
California$18$8027775-0.9%
Virginia$18$4766438-2.1%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber