Blood test, PSA (prostate screen)
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $18
- Cash Discount Price: $135
- vs. Medicare Baseline: 0.98x 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 - $22 | 98% |
| United Mine Workers Of America | $18 | 98% |
| Humana | $18 | 98% |
| Aetna | $18 - $23 | 98% |
| Providrs Care Network | $18 | 98% |
| Blue Cross Blue Shield | $18 | 98% |
| Lantern Specialty Care | $29 | 158% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Kansas Spine & Specialty Hospital, Llc in Wichita, KS, the facility's cash median price is $135.00, while the median negotiated rate across seven payers is $18.00. This negotiated rate is significantly lower than the facility's gross charge of $207.00 and aligns closely with the state average of $18.00. The Medicare benchmark for this service is $18.39, meaning the negotiated rate represents approximately 98% of the Medicare amount, which falls within the typical range of fair pricing (120% to 150% of Medicare). Patients with high-deductible plans may find that paying the cash price of $135.00 upfront is more cost-effective than relying on insurance, as the negotiated rate of $18.00 is often subject to deductibles and co-pays that could exceed the cash amount.
To ensure you receive the most accurate pricing, it is important to request an itemized billing audit before finalizing payment, as summary bills often obscure individual code costs and potential errors. If you choose to pay out-of-pocket, ask the billing department specifically about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if paid in full within a short window. Additionally, while the facility is in-network for several major carriers, remember that commercial rates are contractual ceilings and do not guarantee the lowest possible price; always verify the specific allowed amount for your plan before scheduling. For this service, the facility is owned by a physician group, and