Blood test, PSA (prostate screen)
Facility: Lane County Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $128
- Cash Discount Price: $132
- vs. Medicare Baseline: 6.96x 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 696% of the Medicare baseline (a markup of 596%). 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 |
|---|---|---|
| Aetna | $115 - $128 | 625% |
| UnitedHealthcare | $115 - $135 | 625% |
| Medicaid / KanCare | $128 - $148 | 696% |
| Healthy Blue Mcr Adv - All Other Plans | $128 - $135 | 696% |
| Healthy Blue Mcaid | $128 - $135 | 696% |
| Wppa Providers-All Plans | $192 - $202 | 1044% |
Consumer Guidance & Cost Commentary
For the CPT code 84153, representing a prostate-specific antigen (PSA) blood test, Lane County Hospital in Dighton, Kansas, lists a cash price of $132.00. This cash rate is notably higher than the state average, which is $115.00, and exceeds the facility's own median negotiated rate of $128.00. While commercial payers like Aetna and UnitedHealthcare have negotiated rates ranging from $115 to $148, patients with high-deductible plans may find the cash price more affordable if their insurance negotiated rate exceeds $132.00. To ensure you receive the best possible price, it is essential to verify your specific plan's allowed amount before scheduling, as in-network rates vary significantly by carrier.
The facility's pricing structure reflects a government-owned Critical Access Hospital model, with a Medicare benchmark of $18.39 serving as the baseline for cost evaluation. Although the commercial negotiated rates average 200% to 300% of the Medicare amount, patients should be aware that commercial contracts often include administrative overhead that inflates the baseline price. If you are self-paying, you may be eligible for a prompt-pay discount by requesting a self-pay classification prior to check-in, which can reduce the total cost. Additionally, if you receive an itemized bill, review it carefully for errors such as unbundled codes or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.