Blood test, PSA (prostate screen)
Facility: Ashland Health Center
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $115
- Cash Discount Price: $106
- vs. Medicare Baseline: 6.25x 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 625% of the Medicare baseline (a markup of 525%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $32 - $57 | 174% |
| Compalliance-All Plans | $76 - $135 | 413% |
| Health Partners Of Kansas-All Plans | $81 - $144 | 440% |
| Multiplan-All Plans | $93 - $166 | 506% |
| Medica Mcare - All Plans | $95 - $169 | 517% |
| Healthy Blue Mcr Adv - All Other Plans | $95 - $169 | 517% |
| Health Choice-All Plans | $95 - $169 | 517% |
| Aetna | $95 - $169 | 517% |
| Medicaid / KanCare | $95 - $169 | 517% |
| UnitedHealthcare | $95 - $169 | 517% |
| Medicare (plans) | $95 - $169 | 517% |
| Providers Care (Wppa)-All Plans | $142 - $254 | 772% |
Consumer Guidance & Cost Commentary
For CPT code 84153, a blood test for prostate screening, Ashland Health Center in Ashland, KS, lists a cash median price of $106.00 and a median negotiated rate of $115.00. While the facility is a Critical Access Hospital, the cash price is notably higher than the Medicare benchmark of $18.39, reflecting the standard administrative markup inherent in commercial billing. Patients with high-deductible plans may find the cash price more advantageous than the negotiated rate, as the latter often includes administrative overhead that can inflate the final cost. It is important to note that the cash price does not represent the lowest possible amount; patients should explicitly ask the facility about "self-pay" or "prompt-pay" discounts, which can reduce the total bill by 20% to 50% if paid in full upfront.
The data indicates that this specific service is priced significantly higher than the state average, with the facility's cash median of $106.00 exceeding the state benchmark. However, the facility's negotiated rates range widely across payers, from a low of $32 with Blue Cross Blue Shield to a high of $254 with Providers Care (Wppa), demonstrating that in-network status does not guarantee a uniform price. To ensure you are receiving the best possible rate, verify your specific plan's allowed amount before scheduling, as some insurers may negotiate lower rates than the facility's published median. Additionally, if you receive an itemized bill, review it 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