Blood test, PSA (prostate screen)
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $55
- Cash Discount Price: $40
- vs. Medicare Baseline: 2.99x 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 299% of the Medicare baseline (a markup of 199%). 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 |
|---|---|---|
| Web Tpa [2115] | $55 | 299% |
| Lucent Health [6000] | $55 | 299% |
| Aetna | $55 | 299% |
| Hooray Health [8000] | $55 | 299% |
| Blue Cross Blue Shield | $55 | 299% |
| Black Lung [6055] | $55 | 299% |
| Oncology Patient Assistance Programs [2295] | $55 | 299% |
| Healthcare Highways [2210] | $55 | 299% |
| Department Of Corrections [1340] | $67 | 364% |
| American Postal Workers Union [1070] | $78 | 424% |
| National Association Of Letter Carriers [1695] | $78 | 424% |
| Cigna | $78 | 424% |
| Healthpartners [1500] | $78 | 424% |
| Humana | $79 | 430% |
| Administrative Concepts [1005] | $104 | 566% |
| Multiplan [1680] | $104 | 566% |
| First Health [1375] | $104 | 566% |
| American Healthcare [1055] | $104 | 566% |
| Coventry Healthcare [1320] | $110 | 598% |
| Ks Disability Determination [6090] | $134 | 729% |
Consumer Guidance & Cost Commentary
For the blood test procedure (CPT 84153) at the University of Kansas Health System - St Francis Campus in Topeka, KS, the facility's cash median rate is $40.00, which is significantly lower than the state average of $134.00. While many commercial payers have negotiated rates ranging from $55 to $134, patients with high-deductible plans may find paying the cash price of $40.00 more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to note that while the facility is a voluntary non-profit church-owned acute care hospital, patients should verify their specific plan's allowed amount before scheduling, as some in-network contracts can result in higher out-of-pocket costs than self-pay options.
To avoid unexpected balance billing, patients should be aware that the No Surprises Act generally protects against surprise bills for out-of-network services at in-network facilities, though it is crucial to request a full itemized CPT-coded bill before paying any invoice. Hospitals often issue summary bills that obscure individual charges, so consumers should demand a detailed breakdown to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. Additionally, patients should proactively inquire about "prompt-pay" discounts or self-pay rates before check-in, as paying the bill upfront can sometimes bypass administrative fees and reduce the total cost, especially when the insurance-allowed amount is higher than the cash price.