Blood test, PSA (prostate screen)
Facility: Saint John Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $19
- Cash Discount Price: $18
- vs. Medicare Baseline: 1.03x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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 | $18 | 98% |
| Midland Care Connection | $18 | 98% |
| Tricare | $18 | 98% |
| UnitedHealthcare | $18 - $26 | 98% |
| Medicaid / KanCare | $18 | 98% |
| Medicare (plans) | $18 | 98% |
| Aetna | $18 - $32 | 98% |
| Kansas Superior Select | $19 | 103% |
| Healthy Blue | $19 | 103% |
| Celtic | $19 - $117 | 103% |
| Corizon | $26 | 141% |
| Well Path | $26 | 141% |
| Employer Direct Healthcare | $26 | 141% |
| Centurion | $28 | 152% |
| Naphcare | $28 | 152% |
| Blue Cross Blue Shield | $32 - $68 | 174% |
| Comp Alliance Workers Comp | $37 | 201% |
| Oha Networks | $40 | 218% |
| Worker Compensation | $41 | 223% |
Consumer Guidance & Cost Commentary
For this blood test service at Saint John Hospital in Leavenworth, KS, the cash price is $18.00, which is significantly lower than the facility's negotiated rates with major payers like UnitedHealthcare ($18–$26) and Celtic ($19–$117). While the facility's cash rate is also lower than the state average for this procedure, patients with high-deductible plans may find that paying the cash price upfront is more cost-effective than relying on insurance, as the negotiated amounts often exceed the cash rate. It is important to note that while the facility is an in-network location for many insurers, the No Surprises Act generally protects patients from balance billing for out-of-network services at in-network hospitals, though patients should still verify their specific plan details and ask the hospital directly about any available self-pay or prompt-pay discounts before scheduling.
The Medicare benchmark for this service is $18.39, which serves as a reliable baseline for evaluating the facility's pricing structure. Although the cash rate of $18.00 is slightly below the Medicare amount, the median negotiated rate across payers is $19.00, indicating that commercial insurance contracts often result in higher out-of-pocket costs for patients who have not yet met their deductibles. Given that over 80% of hospital bills contain errors, patients should request a detailed, itemized statement rather than accepting a summary bill, and they should dispute any unexpected charges in writing to ensure accuracy. Ultimately, comparing the cash price against the Medicare rate and the facility's specific negotiated rates provides the clearest picture of the true cost of care.