Blood test, PSA (prostate screen)
Facility: Kansas Medical Center Llc
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $18
- Cash Discount Price: $88
- 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 |
|---|---|---|
| United | $9 | 49% |
| Indian Health | $17 | 92% |
| Humana | $18 | 98% |
| Medicaid / KanCare | $18 | 98% |
| Blue Cross Blue Shield | $18 - $43 | 98% |
| Medadv_Wellcare | $18 | 98% |
| Ambetter / Centene | $18 | 98% |
| Three_Rivers | $37 | 201% |
| Wppa | $49 - $68 | 266% |
| Aetna | $58 | 315% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Kansas Medical Center Llc in Andover, KS, the cash price is $88.00, which is lower than the facility's negotiated rates of $18.00 and the median paid amount of $104.00. While the facility's cash rate is significantly lower than its gross charge of $146.00, patients should be aware that commercial insurance plans often negotiate rates that can exceed cash prices due to administrative costs and contract structures. If you have a high-deductible plan or have not yet met your deductible, paying the cash price of $88.00 upfront may result in immediate savings compared to having your insurance process a claim that could exceed this amount. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these incentives can further reduce the final cost for patients paying out-of-pocket.
This service is subject to federal protections under the No Surprises Act, which prohibits balance billing for out-of-network providers at in-network facilities, including for emergency care and certain non-emergency ancillary services like lab tests. If you receive a bill for the difference between the allowed amount and the full charge, you should dispute it in writing rather than paying immediately, as these balances may be illegal. Additionally, since over 80% of hospital bills contain errors, you are encouraged to request a detailed, itemized statement to review specific CPT codes and identify any unbundled charges or services not rendered. To ensure you are getting fair value, compare the facility's rates against the Medicare benchmark of $18.39; while commercial rates