Blood test, PSA (prostate screen)
Facility: Salina Regional Health Center
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $162
- Cash Discount Price: $126
- vs. Medicare Baseline: 8.81x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 881% of the Medicare baseline (a markup of 781%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $43 - $45 | 234% |
| Preferred Phsic | $108 | 587% |
| Preferred Healthcare - All Other Plans | $146 | 794% |
| Cigna | $162 | 881% |
| Providers Care (Wppa)-All Plans | $162 | 881% |
| Aetna | $162 | 881% |
| Multiplan (Mpi)-All Plans | $162 | 881% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Salina Regional Health Center in Salina, KS, the facility's cash median price is $126.00, which is lower than the state average of $146.00. While the facility's negotiated rate for in-network insurance plans averages $162.00, this amount exceeds the cash price, meaning patients with high-deductible plans might save money by paying cash directly, provided they qualify for a prompt-pay discount. It is important to note that the facility's negotiated rate is significantly higher than the Medicare benchmark of $18.39, illustrating how commercial contracts often exceed the federal cost baseline. Patients should verify their specific plan details and ask the hospital about self-pay or prompt-pay discounts before scheduling to ensure they are not paying the full negotiated rate when a lower cash option is available.
The facility's negotiated rates range from $43 to $162 across seven different payers, with the highest negotiated amount of $162.00 being 8.8% higher than the Medicare rate for this specific service. This markup reflects the administrative costs and contract dynamics inherent in commercial insurance billing, where rates can average 200% to 300% of the Medicare benchmark. To avoid unexpected costs, patients should request an itemized billing audit to confirm that all charges are accurate and that no services were unbundled or billed incorrectly. Additionally, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, so they should not feel pressured to pay surprise bills immediately but should instead request a formal audit if discrepancies arise.