Blood test, PSA (prostate screen)
Facility: Mercy Hospital Columbus
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $151
- Cash Discount Price: $126
- vs. Medicare Baseline: 8.21x 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 821% of the Medicare baseline (a markup of 721%). 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 |
|---|---|---|
| Centivo Contracted [320505] | $2 | 11% |
| Humana | $16 - $195 | 87% |
| Medicaid / KanCare | $16 - $149 | 87% |
| UnitedHealthcare | $17 - $170 | 92% |
| Blue Cross Blue Shield | $17 - $149 | 92% |
| Medicare (plans) | $18 - $155 | 98% |
| Novasys Contracted [320285] | $18 | 98% |
| Aetna | $18 - $184 | 98% |
| Ambetter / Centene | $18 - $149 | 98% |
| Insurance System Inc Contracted [320465] | $79 - $88 | 430% |
| Health Systems Inc Contracted [320174] | $79 - $88 | 430% |
| Administrative Payor Contracted [320005] | $83 - $92 | 451% |
| Kindful Hospice Contracted [320434] | $134 - $149 | 729% |
| Mercy Hospice Okc [20252] | $134 - $149 | 729% |
| Mercy Mgd Behavioral Health Contracted [320259] | $134 - $149 | 729% |
| Pace Of The Ozarks Contracted [320518] | $134 - $149 | 729% |
| Cross Timbers Hospice [20098] | $134 - $149 | 729% |
| Home State Health Plan Contracted [320187] | $134 - $149 | 729% |
| Globalhealth Contracted [320145] | $134 - $149 | 729% |
| Kindful Hospice [20434] | $134 - $149 | 729% |
| Halo Hcr Inc Hospice Contracted [320432] | $134 - $149 | 729% |
| Tricare | $134 - $149 | 729% |
| Elara Caring Aspire Hospice [20433] | $134 - $149 | 729% |
| Cigna | $134 - $149 | 729% |
| Cherokee Nation Health Serv Contracted [320066] | $134 - $149 | 729% |
| Centurion Of Missouri [20459] | $134 - $149 | 729% |
| Medical Associates Health Contracted [320444] | $134 - $149 | 729% |
| Provider Partners Health Plans Contracted [320450] | $134 - $149 | 729% |
| Indian Health Service Contracted [320198] | $134 - $149 | 729% |
| Qual Choice Contracted [320325] | $134 - $149 | 729% |
| Dept Of Veteran Affairs Contracted [320106] | $134 - $149 | 729% |
| Halo Hcr Inc Hospice [20432] | $134 - $149 | 729% |
| Healthscope Contracted [320182] | $142 - $158 | 772% |
| Workers Comp [20426] | $147 - $174 | 799% |
| United Medical Resources Contracted [320454] | $153 - $195 | 832% |
| Medica Contracted [320239] | $165 - $184 | 897% |
| Healthlink Contracted [320179] | $166 - $195 | 903% |
| Usa Managed Care Org Contracted [320429] | $166 - $184 | 903% |
| Mercy Benefit Admin Contracted [320251] | $166 - $195 | 903% |
| First Health Contracted [320128] | $166 - $184 | 903% |
| Federal Medical Center Contracted [320127] | $166 - $184 | 903% |
| American Healthcare Alliance Contracted [320020] | $166 - $184 | 903% |
| Preferred Health Plan Contracted [320522] | $166 - $184 | 903% |
| Imagine 360 Contracted [320494] | $175 - $195 | 952% |
| Auxiant Contracted [320462] | $175 - $195 | 952% |
| Benefit Management Contracted [320052] | $175 - $195 | 952% |
| 90 Degree Benefits Contracted [320436] | $175 - $195 | 952% |
| Edison Health Solutions Contracted [320502] | $175 - $195 | 952% |
| Reflect Health Contracted [320492] | $175 - $195 | 952% |
| Yuzu Health Contracted [320521] | $175 - $195 | 952% |
| Point C Contracted [320238] | $175 - $195 | 952% |
| Aither Health Contracted [320449] | $175 - $195 | 952% |
| Show-Me Health Administrators Contracted [320483] | $175 - $195 | 952% |
| Private Health Care Systems Contracted [320320] | $175 - $195 | 952% |
| Ppo Plus Contracted [320310] | $175 - $195 | 952% |
| Ebms Contracted [320493] | $175 - $195 | 952% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Mercy Hospital Columbus, the facility's cash price of $126.00 is significantly lower than the gross charge of $195.00 and sits below the median negotiated rate of $151.00 across 56 payers. While Medicare reimburses $18.39 for this service, commercial insurance contracts typically range from $2 to $195, with many plans paying between $134 and $149. Because commercial negotiated rates often exceed the cash price, patients with high-deductible plans may save money by paying out-of-pocket directly, provided they verify the facility's "self-pay" or "prompt-pay" discounts before scheduling. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request an itemized bill to ensure no unbundled charges or services not rendered are included.
This facility, a Critical Access Hospital in Columbus, KS, operates under a voluntary non-profit church ownership structure. The data reflects pricing for the 2026-06 vintage, where the cash median of $126.00 serves as a key benchmark for cost transparency. Patients should be aware that commercial rates are often inflated by administrative overhead and contract dynamics, sometimes reaching 200% to 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of Medicare. To avoid unexpected costs, consumers should compare the facility's specific rates against state or county averages and insist on a detailed, line-by-line itemized