Blood test, PSA (prostate screen)
Facility: Wichita County Health Center
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $105
- Cash Discount Price: $92
- vs. Medicare Baseline: 5.71x 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 571% of the Medicare baseline (a markup of 471%). 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 |
|---|---|---|
| Medicaid / KanCare | $95 | 517% |
| UnitedHealthcare | $115 | 625% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) at Wichita County Health Center, the negotiated rates for Medicaid/KanCare and UnitedHealthcare are both $115, which matches the facility's cash median of $92.00. This price point is notably higher than the state average for this service, as indicated by the 5.7% variance against Medicare benchmarks. While commercial insurance contracts often set ceilings that exceed cash prices due to administrative overhead, patients with high-deductible plans may find paying the cash rate of $92.00 directly more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the deductible has not yet been met.
To ensure you are receiving the best possible rate, it is important to verify the facility's self-pay or prompt-pay discounts before scheduling your visit. Hospitals frequently offer significant reductions for upfront payments, bypassing the administrative costs associated with insurance claims processing. Since this facility is a Critical Access Hospital in Leoti, KS, you should contact the billing department to confirm if a prompt-pay discount is available and request a waiver of insurance submission to avoid automatic claims that might void any cash savings. Always review your itemized bill for accuracy, as over 80% of hospital bills contain errors, and ensure you are comparing rates against the Medicare benchmark rather than the inflated chargemaster list.