Blood test, PSA (prostate screen)
Facility: Rawlins County Health Center
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $148
- Cash Discount Price: $145
- vs. Medicare Baseline: 8.05x 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 805% of the Medicare baseline (a markup of 705%). 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 | $68 | 370% |
| UnitedHealthcare | $148 | 805% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) at Rawlins County Health Center in Atwood, Kansas, the facility's cash median price is $145.00, which is lower than the negotiated rates of $148.00 paid by UnitedHealthcare and $68.00 paid by Blue Cross Blue Shield. While commercial insurance contracts often set a ceiling on what patients pay, these negotiated amounts can sometimes exceed the cash price, making self-pay a potentially more affordable option for those with high-deductible plans. The facility's cash rate is also notably higher than the Medicare benchmark of $18.39, reflecting the standard markup found in commercial healthcare pricing where administrative costs and contract dynamics inflate the baseline price by 20% to 40% compared to federal reimbursement rates.
Patients should be aware that while the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the specific negotiated rates vary significantly by insurer, with Blue Cross Blue Shield paying a lower $68.00 compared to UnitedHealthcare's $148.00. To ensure you are receiving the best possible price, it is advisable to explicitly request "self-pay" or "prompt-pay" discounts before scheduling your visit, as hospitals often offer fee reductions of 20% to 50% for upfront payments that bypass costly claims processing. Additionally, since over 80% of hospital bills contain errors, you should request a full itemized CPT-coded statement rather than accepting a summary bill, and always verify your deductible status before using insurance to avoid unexpected out-of-pocket costs.