Blood test, PSA (prostate screen)
Facility: Pratt Regional Medical Center
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $68
- Cash Discount Price: $59
- vs. Medicare Baseline: 3.70x 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 370% of the Medicare baseline (a markup of 270%). 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 |
|---|---|---|
| Christian Health Aid | $23 - $104 | 125% |
| UnitedHealthcare | $25 - $141 | 136% |
| Health Partners Of Kansas | $26 - $117 | 141% |
| Aetna | $27 - $124 | 147% |
| Choicecare | $30 - $138 | 163% |
Consumer Guidance & Cost Commentary
For the CPT code 84153, representing a prostate-specific antigen (PSA) blood test at Pratt Regional Medical Center in Pratt, Kansas, the facility's cash median price is $59.00. This cash rate is notably lower than the facility's negotiated rates, which range from $23 to $141 depending on the insurance carrier. While the facility's cash price is significantly below the gross chargemaster of $84.00, patients should be aware that commercial insurance plans often pay negotiated rates that can exceed the cash price. For individuals with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $59.00 upfront may result in lower total costs compared to having the insurance process a claim that settles for a higher negotiated amount.
To ensure you are receiving the most accurate pricing, it is advisable to request a prompt-pay discount if you choose to pay out-of-pocket, as hospitals often offer reductions for upfront payments to bypass administrative billing cycles. Additionally, while the facility's cash rate is competitive, the Medicare benchmark for this service is $18.39, which serves as a baseline for evaluating the facility's overall pricing structure. The facility's negotiated rate of $68.00 is higher than the Medicare amount, reflecting standard commercial pricing dynamics. Patients should verify their specific plan details and ask the billing department about self-pay or prompt-pay discounts before scheduling to avoid unexpected balance billing, especially if the service is not covered under their current network agreements.