Blood test, PSA (prostate screen)
Facility: Providence Medical Center
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $19
- Cash Discount Price: $18
- vs. Medicare Baseline: 1.03x 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 |
|---|---|---|
| UnitedHealthcare | $18 - $30 | 98% |
| Aetna | $18 - $32 | 98% |
| Medicaid / KanCare | $18 | 98% |
| Blue Cross Blue Shield | $18 - $44 | 98% |
| Cigna | $18 | 98% |
| Medicare (plans) | $18 | 98% |
| Tricare | $18 | 98% |
| Midland Care Connection | $18 | 98% |
| Healthy Blue | $19 | 103% |
| Celtic | $19 - $29 | 103% |
| Kansas Superior Select | $19 | 103% |
| Corizon | $24 | 131% |
| Well Path Prison | $26 | 141% |
| Employer Direct Healthcare | $26 | 141% |
| Centurion | $28 | 152% |
| Naphcare | $28 | 152% |
| Comp Alliance - Fka Compresults Worker Compensation | $37 | 201% |
| Oha Networks | $40 | 218% |
| Worker Compensation | $41 | 223% |
Consumer Guidance & Cost Commentary
For this blood test, PSA (prostate screen) at Providence Medical Center in Kansas City, KS, the facility's cash median rate is $18.00, which is significantly lower than the state average of $49.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $18 to $32, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to note that cash-pay can sometimes be cheaper than insurance if the negotiated rate exceeds the cash price, so patients should verify their specific plan's allowed amount before scheduling. Additionally, patients should ask the hospital about "self-pay" or "prompt-pay" discounts, which can offer further reductions for upfront payment.
The facility's Medicare benchmark rate is $18.39, which serves as the objective baseline for evaluating pricing markup, as commercial negotiated rates often average 200% to 300% of this amount while fair pricing is typically defined as 120% to 150%. Although the facility's negotiated rates appear competitive when compared to the cash price, patients should be aware that insurance administrative structures can inflate baseline prices by 20% to 40%. To ensure you are receiving the best possible rate, it is recommended to request an itemized billing audit to identify any errors, double-billing, or unbundled codes, as over 80% of hospital bills contain errors. Finally, if you choose to pay out-of-network, be aware that balance billing could occur, though the No Surprises Act provides federal protections against surprise bills for emergency