Blood test, PSA (prostate screen)
Facility: Centura St. Catherine-Dodge City
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $66
- Cash Discount Price: $37
- vs. Medicare Baseline: 3.59x 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 359% of the Medicare baseline (a markup of 259%). 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 |
|---|---|---|
| Cigna | $18 | 98% |
| Aetna | $18 - $75 | 98% |
| Blue Cross Blue Shield | $18 - $80 | 98% |
| Kansas Health | $18 | 98% |
| Medicare (plans) | $18 | 98% |
| Kaiser | $18 | 98% |
| Humana | $18 | 98% |
| Centura Employee Plan | $23 | 125% |
| UnitedHealthcare | $62 | 337% |
| Wpaa | $66 | 359% |
| Multiplan | $75 - $84 | 408% |
| Christian Health Aid | $75 | 408% |
| Health Partners Of Kansas | $84 | 457% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Centura St. Catherine-Dodge City, the facility's cash median price is $37.00, which is significantly lower than the state of Kansas average of $66.00. While many commercial payers have negotiated rates ranging from $18 to $84, the cash price remains the most transparent benchmark for patients. It is important to note that for individuals with high-deductible plans, paying the cash price of $37.00 upfront can sometimes be more cost-effective than relying on insurance, as the negotiated rates for some plans exceed this amount. Patients should verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final cost.
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 figure. In this case, the median negotiated rate of $66.00 is approximately 3.6 times the Medicare amount, reflecting the administrative costs and contract dynamics inherent in commercial insurance. If you receive a bill that includes charges from out-of-network providers, such as emergency physicians or lab services, you may be subject to balance billing for the difference between the provider's full charge and your insurance allowed amount. However, the No Surprises Act protects patients from these surprise bills for emergency care and non-emergency services at in-network facilities. If you do receive a balance bill, you should dispute it in writing with your insurer rather than paying immediately, and you