Blood test, PSA (prostate screen)
Facility: Grisell Memorial Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $86
- Cash Discount Price: $138
- vs. Medicare Baseline: 4.68x 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 468% of the Medicare baseline (a markup of 368%). 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 |
|---|---|---|
| UnitedHealthcare | $27 - $108 | 147% |
| Blue Cross Blue Shield | $64 | 348% |
| Humana | $145 | 788% |
| Medicaid / KanCare | $145 | 788% |
Consumer Guidance & Cost Commentary
For the blood test code 84153 (PSA screening) at Grisell Memorial Hospital in Ransom, Kansas, the facility's cash price of $138.00 is notably higher than the state average of $127.00. While commercial insurance plans like UnitedHealthcare and Blue Cross Blue Shield have negotiated rates ranging from $27 to $108, these figures represent the maximum amounts insurers are willing to pay, not necessarily the lowest possible cost for a patient. In many cases with high-deductible plans, paying the cash price directly can be more affordable than using insurance, as the negotiated rate often exceeds the cash price due to administrative overhead and contract structures. Patients should verify their specific plan's deductible status before scheduling, as using insurance without meeting the deductible could result in paying the full negotiated amount rather than the cash rate.
The facility's Medicare benchmark of $18.39 serves as a critical baseline for understanding the markup on this service, with the cash price representing a significant increase over the federal standard. Although the facility is a Critical Access Hospital owned by a Government Hospital District, the data does not indicate a specific county or state average for this specific procedure to provide a direct comparison. Regardless of the facility type, consumers should proactively request a prompt-pay discount, which can reduce bills by 20% to 50% if paid upfront, bypassing the costly insurance billing cycle. Additionally, patients should insist on an itemized bill to ensure no errors or unbundled charges exist, as summary invoices often obscure the true cost of services rendered.