Blood test, PSA (prostate screen)
Facility: Kansas Surgery & Recovery Center
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $19
- Cash Discount Price: $75
- 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 | $8 - $18 | 44% |
| Blue Cross Blue Shield | $18 - $45 | 98% |
| Aetna | $18 - $61 | 98% |
| Triwest | $19 | 103% |
| Cigna | $31 | 169% |
Consumer Guidance & Cost Commentary
For the prostate screening service (CPT 84153) at Kansas Surgery & Recovery Center in Wichita, KS, the cash median price is $75.00, which matches the facility's gross charge. This rate is significantly higher than the state average for this procedure, as indicated by a ratio of 1.0 relative to Medicare, suggesting the facility's pricing aligns closely with federal benchmarks rather than offering a discount. While commercial insurance plans like UnitedHealthcare, Blue Cross Blue Shield, Aetna, Triwest, and Cigna negotiate rates ranging from $8 to $61 depending on the specific plan, patients should be aware that cash-paying can sometimes be more cost-effective if their insurance negotiated rate exceeds the cash price. It is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if settled upfront.
Patients should also be cautious regarding balance billing and itemized billing practices. Although the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, unexpected charges can still occur for ancillary services or if a waiver is signed inadvertently. To ensure accuracy, request a full itemized bill that lists every CPT code and unit cost, as summary bills often hide errors or unbundled charges. Since over 80% of hospital bills contain mistakes, disputing any discrepancies in writing with the billing supervisor is the most effective way to reduce medical debt. By comparing the facility's rates against the Medicare benchmark of $18.39 and understanding the administrative costs embedded in commercial negotiations, consumers can make informed decisions about whether to pay cash, use