Blood test, PSA (prostate screen)
Facility: Rooks County Health Center
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $118
- Cash Discount Price: $98
- vs. Medicare Baseline: 6.42x 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 642% of the Medicare baseline (a markup of 542%). 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 |
|---|---|---|
| Veterans Admin - All Plans | $24 | 131% |
| Celtic Mcr Adv | $62 | 337% |
| Tricare | $62 | 337% |
| Celtic Comm - All Other Plans | $68 | 370% |
| Blue Cross Blue Shield | $68 | 370% |
| Aetna | $118 | 642% |
| Preferred Benefits Admin | $118 | 642% |
| UnitedHealthcare | $118 | 642% |
| Health Partners - All Plans | $125 | 680% |
| Preferred Hlthcare - All Other Plans | $125 | 680% |
| Healthy Blue Mcaid - All Plans | $131 | 712% |
Consumer Guidance & Cost Commentary
For the blood test code 84153 (PSA screening) at Rooks County Health Center in Plainville, KS, the facility's cash price of $98.00 is notably lower than the state average of $131.00 and the county average of $118.00. While the facility's negotiated rates with major payers like Aetna, UnitedHealthcare, and Blue Cross Blue Shield range from $62.00 to $131.00, patients with high-deductible plans may find the cash price more advantageous if their insurance allowed amount exceeds $98.00. It is important to note that the facility's cash rate is significantly higher than the Medicare benchmark of $18.39, which serves as the federal baseline for cost, and the median negotiated rate of $118.00 is also above the Medicare amount.
Patients should verify their specific plan's allowed amount before scheduling, as commercial negotiated rates often include administrative overhead that can make them higher than the direct cash price. If you receive a bill that includes charges for out-of-network ancillary services or emergency care at this in-network facility, you may be protected by the No Surprises Act, which prohibits balance billing for these specific scenarios. To ensure you are not overcharged, always request a full itemized bill before paying and consider asking for a prompt-pay discount if you choose to settle the account directly with the hospital.