Blood test, PSA (prostate screen)
Facility: Kearny County Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $178
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 9.68x 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 968% of the Medicare baseline (a markup of 868%). 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 |
|---|---|---|
| Community Care Health Plan Of | $178 | 968% |
| Humana | $178 | 968% |
| Blue Cross Blue Shield | $178 | 968% |
| UnitedHealthcare | $178 | 968% |
| Wps Gha - Mac J5 Part A | $178 | 968% |
Consumer Guidance & Cost Commentary
For the CPT code 84153, representing a prostate-specific antigen (PSA) blood test, the negotiated rate at Kearny County Hospital in Lakin, Kansas, is $178.00. This amount is identical to the facility's cash median and the lowest and highest negotiated rates observed across all five payers, including Community Care Health Plan, Humana, and Blue Cross Blue Shield. While the facility is a Critical Access Hospital with government-local ownership, the data does not provide specific cash or median paid figures for comparison. However, the Medicare benchmark for this service is $18.39, which serves as the objective baseline for evaluating pricing markup. Commercial negotiated rates for this test are significantly higher than the Medicare rate, reflecting the standard administrative and contractual structures inherent in insurance billing.
Patients should be aware that while in-network rates are capped, they may not always represent the lowest possible price. In cases where a patient's insurance deductible has not been met, the negotiated rate of $178.00 could be the actual amount owed, whereas paying cash directly might result in a lower total. It is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% for upfront payment. Additionally, since the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients can be confident that the $178.00 rate is the maximum they will be charged for this service through their insurance, provided the facility remains in-network.