Blood test, PSA (prostate screen)
Facility: Mcpherson Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $138
- Cash Discount Price: $133
- vs. Medicare Baseline: 7.50x 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 750% of the Medicare baseline (a markup of 650%). 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 |
|---|---|---|
| Tricare | $16 | 87% |
| Humana | $18 | 98% |
| Blue Cross Blue Shield | $18 | 98% |
| UnitedHealthcare | $18 - $311 | 98% |
| Wellcare Mcr Adv - All Plans | $18 | 98% |
| Healthy Blue Mcr Adv | $18 | 98% |
| Va Ccn - All Plans | $18 | 98% |
| Ambetter / Centene | $21 | 114% |
| Wppa - All Plans | $68 - $218 | 370% |
| Central Plains - All Plans | $73 - $233 | 397% |
| Medical Associates - All Plans | $73 - $233 | 397% |
| Christian Health Aid - All Plans | $78 - $249 | 424% |
| Aetna | $80 - $311 | 435% |
| Multiplan - All Plans | $87 - $280 | 473% |
| Health Partners - All Plans | $92 - $295 | 500% |
| Cigna | $92 - $295 | 500% |
| First Health - All Plans | $92 - $295 | 500% |
| Medicaid / KanCare | $97 - $311 | 527% |
| Health Blue Mcaid - All Other Plans | $99 - $317 | 538% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at McPherson Hospital in McPherson, KS, the cash price is $133.00, which is 7.5% higher than the Medicare benchmark rate of $18.39. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $18 to over $311, these amounts often exceed the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find paying the cash price of $133.00 more cost-effective than relying on insurance, as the negotiated rates can be significantly higher than the cash amount. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket expenses than paying cash directly.
To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. These discounts bypass the administrative overhead of insurance claims processing and provide immediate liquidity to the facility. Additionally, if you have insurance, ensure you are aware of your plan's network status, as in-network rates are contractually capped but may still be higher than cash prices. If you receive a bill, always request a detailed, itemized statement to review specific CPT codes and avoid paying for services that were not rendered or charges that were incorrectly bundled.