Blood test, PSA (prostate screen)
Facility: Lmh
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $30
- Cash Discount Price: $62
- vs. Medicare Baseline: 1.63x 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.
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 | $17 - $162 | 92% |
| UnitedHealthcare | $17 - $254 | 92% |
| Humana | $18 - $250 | 98% |
| Medicare (plans) | $18 - $250 | 98% |
| Cigna | $18 - $250 | 98% |
| Haskell Indian Health Services | $18 | 98% |
| Allwell | $19 | 103% |
| Aetna | $20 - $207 | 109% |
| Ambetter / Centene | $28 | 152% |
| Non Contracted | $200 | 1088% |
| First Health | $232 | 1262% |
Consumer Guidance & Cost Commentary
For this prostate screening service (CPT 84153), the facility's cash price of $62.00 is significantly lower than the negotiated rates charged by major insurers like Blue Cross Blue Shield ($17–$162) and UnitedHealthcare ($17–$254). While the facility is located in Lawrence, KS, the data does not provide specific county or state average figures for comparison; however, the cash rate is notably lower than the Medicare benchmark of $18.39 when adjusted for the facility's 1.6x multiplier, suggesting a markup relative to federal standards. Patients with high-deductible plans may find it financially advantageous to pay the $62.00 cash price directly, as the negotiated rates for many commercial payers often exceed this amount, potentially resulting in higher out-of-pocket costs if the patient's deductible is not yet met.
To minimize unexpected costs, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the total amount owed. It is also important to request a full itemized bill containing specific CPT codes rather than accepting a summary invoice, which may obscure unbundled charges or services not rendered. If a patient receives a balance bill from an out-of-network provider, such as the non-contracted rate of $200 listed here, they should not pay immediately but instead dispute the charge with their insurer under the No Surprises Act, which protects against balance billing for emergency and non-emergency services at in-network facilities.