Blood test, PSA (prostate screen)
Facility: F W Huston Medical Center
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $93
- Cash Discount Price: $97
- vs. Medicare Baseline: 5.06x 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 506% of the Medicare baseline (a markup of 406%). 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% |
| Aetna | $91 | 495% |
| Humana | $96 | 522% |
| Cigna | $103 | 560% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at F W Huston Medical Center in Winchester, KS, the facility's cash median price is $97.00, which is lower than the state average of $121.00. While the facility's negotiated rates for in-network payers like Blue Cross Blue Shield, Aetna, Humana, and Cigna range from $68 to $103, these amounts are generally higher than the cash price. This pricing structure suggests that patients with high-deductible plans or those without insurance may save money by paying the cash rate directly, as the facility's cash price is below the negotiated rates offered to commercial insurers.
To maximize savings, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is important to note that while the facility is a Critical Access Hospital owned by a voluntary non-profit, the standard billing process for insurance claims often includes administrative overhead that inflates the cost compared to direct payment. Consumers should avoid paying balance bills immediately if they receive them, as the No Surprises Act may protect them from unexpected charges for out-of-network services at this in-network facility, and they should always request a detailed, itemized bill to verify all charges before settling.