Blood test, PSA (prostate screen)
Facility: St. Catherine Hospital - Garden City
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $63
- Cash Discount Price: $90
- vs. Medicare Baseline: 3.43x 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 343% of the Medicare baseline (a markup of 243%). 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 |
|---|---|---|
| Medicare (plans) | $18 | 98% |
| UnitedHealthcare | $18 - $114 | 98% |
| Kaiser | $18 - $73 | 98% |
| Aetna | $18 - $155 | 98% |
| Blue Cross Blue Shield | $18 - $81 | 98% |
| Devoted Health | $18 | 98% |
| Humana | $18 | 98% |
| Kansas Health | $18 | 98% |
| Innovage | $18 | 98% |
| Cigna | $18 - $24 | 98% |
| Centura Employee Plan | $23 | 125% |
| United Colorado Doctor'S Plan | $28 | 152% |
| Direct To Employer | $32 - $106 | 174% |
| Denver Health | $63 | 343% |
| Peak Health | $103 | 560% |
| Wpaa | $129 | 701% |
| Christian Health Aid | $147 | 799% |
| Multiplan | $166 - $225 | 903% |
| Health Partners Of Kansas | $179 | 973% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at St. Catherine Hospital in Garden City, Kansas, the facility's cash price of $90.00 is significantly higher than the state average of $66.00 and the county average of $63.00. While Medicare sets a benchmark rate of $18.39 for this service, commercial insurance plans negotiate rates that vary widely, ranging from $18 to $225 across 19 different payers. It is important to note that negotiated rates often include administrative costs and contract premiums, which can inflate the price well above the actual cost of care. Patients with high-deductible plans may find that paying the cash price of $90.00 upfront is more cost-effective than relying on insurance, especially if their plan's negotiated rate exceeds this amount or if they have not yet met their deductible.
Before scheduling this test, patients should explicitly request a "self-pay" or "prompt-pay" discount from the hospital, as these upfront payment incentives can reduce the final bill by 20% to 50%. Additionally, because the facility is an in-network location for many insurers, patients should verify their specific plan's allowed amount rather than assuming the negotiated rate is the lowest possible price, as rates can vary significantly between payers. If a patient receives a bill that includes charges for services not rendered or unbundled components, they should request a full itemized audit to identify errors, as over 80% of hospital bills contain inaccuracies. Finally, under federal protections like the No Surprises Act, patients are generally shielded from balance billing for out-of-network services at in-network facilities, so they