Blood test, PSA (prostate screen)
Facility: University Of Ks Hlth System Great Bend Campus
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $103
- Cash Discount Price: $34
- vs. Medicare Baseline: 5.60x 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 560% of the Medicare baseline (a markup of 460%). 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 |
|---|---|---|
| Meritain Health [503200039] | $72 - $103 | 392% |
| Wppa [503200056] | $72 | 392% |
| Alt Wppa [5032000964] | $72 | 392% |
| Alt Carelon Behavioral Health [503200905] | $86 | 468% |
| Allied National [503999937] | $103 | 560% |
| Aetna | $103 | 560% |
| Php [503200005] | $103 | 560% |
| Aha-Healthcare Preferred [503200050] | $103 | 560% |
| Cigna | $103 - $138 | 560% |
| Alt Meritain Health [503999911] | $103 | 560% |
| First Health [5032000110] | $103 | 560% |
| National Assn Letter Carriers [503200019] | $103 | 560% |
| Correct Care Solutions [50311253] | $120 | 653% |
| Workers Comp [503999901] | $146 | 794% |
| Usa Managed Care [503999030] | $155 | 843% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at the University of KS Hlth System Great Bend Campus, the facility's cash median price is $34.00, which is significantly lower than the negotiated rates paid by most insurance plans. While the facility's negotiated median is $103.00, this amount is still higher than the cash price, illustrating that paying out-of-pocket can sometimes be the most cost-effective option for patients with high-deductible plans. It is important to note that the facility is a Government Hospital District, and patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing the administrative costs associated with insurance claims processing.
When comparing this service to federal benchmarks, the Medicare amount for this code is $18.39. The facility's cash rate of $34.00 is approximately 5.6 times the Medicare amount, while the negotiated rates paid by insurers average around 103.00, which represents a substantial markup over the government baseline. Although the data does not provide specific state or county averages for this procedure, the significant gap between the cash price and the negotiated rates highlights the importance of verifying your plan's allowed amount before receiving care. To avoid unexpected costs, patients should request an itemized bill to ensure no errors exist and 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 prudent to confirm that all ancillary services, such as laboratory tests, are covered under your plan's network agreements.