Blood test, PSA (prostate screen)
Facility: Kansas Heart Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $20
- Cash Discount Price: $73
- vs. Medicare Baseline: 1.09x 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 |
|---|---|---|
| Tricare | $17 | 92% |
| Celtic Mcr Adv | $18 | 98% |
| Medicaid / KanCare | $18 | 98% |
| UnitedHealthcare | $18 | 98% |
| Humana | $18 | 98% |
| Aetna | $21 | 114% |
| Blue Cross Blue Shield | $46 | 250% |
| Wppa - All Plans | $46 | 250% |
| Multiplan - All Plans | $104 | 566% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Kansas Heart Hospital in Wichita, KS, the facility's cash median rate is $73.00, while the negotiated rate paid by insurance plans ranges from $17.00 to $104.00 depending on the carrier. Notably, the cash price of $73.00 is lower than the facility's negotiated rates for several major payers, including Celtic Mcr Adv, Medicaid/KanCare, UnitedHealthcare, Humana, Blue Cross Blue Shield, Wppa, and Multiplan. This suggests that patients with high-deductible plans or those without insurance may find it financially advantageous to pay the cash price directly, as it avoids the administrative markup and higher negotiated fees charged to insured members. Additionally, the facility offers a prompt-pay discount for upfront payments, which can further reduce the final cost for self-pay patients.
When evaluating the facility's pricing against state benchmarks, the Medicare amount for this service is $18.39. The facility's cash rate of $73.00 represents a markup of 1.1 times the Medicare amount, which is consistent with the typical range of 120% to 150% considered fair for commercial pricing. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is still crucial to request an itemized bill to verify all charges. If a patient receives a summary bill, they should demand a detailed line-by-line statement to identify any unbundled codes or services not rendered, ensuring they are not paying for unnecessary items. Finally, before scheduling, patients should explicitly ask