Blood test, PSA (prostate screen)
Facility: Hamilton County Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $132
- Cash Discount Price: $147
- vs. Medicare Baseline: 7.18x 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 718% of the Medicare baseline (a markup of 618%). 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 | $32 - $68 | 174% |
| First Health Coventry - All Plans | $125 | 680% |
| Cigna | $140 | 761% |
| UnitedHealthcare | $140 | 761% |
| Va Ccn - All Plans | $147 | 799% |
| Aetna | $250 | 1359% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Hamilton County Hospital in Syracuse, KS, the cash price is $147.00, which matches the facility's negotiated rate with several major payers including Blue Cross Blue Shield, Cigna, and UnitedHealthcare. While the median amount paid by insurers was $132.00, patients should note that cash payments can sometimes be more cost-effective if your insurance plan has a high deductible or if the negotiated rate exceeds the cash price. The facility, a Critical Access Hospital owned by the local government, offers a self-pay rate of $147.00, and you may be eligible for additional prompt-pay discounts if you settle the bill in full upfront.
When evaluating costs, it is important to compare these rates against the Medicare benchmark of $18.39, which serves as the objective baseline for fair pricing. Although the data does not include specific state or county average figures for this service, the significant difference between the Medicare rate and the commercial cash price highlights the typical markup in healthcare billing. To avoid unexpected charges, patients should request a full itemized bill before paying, as summary invoices can obscure individual line items. Additionally, if you receive a balance bill from an out-of-network provider, you may have protections under the No Surprises Act, and you should dispute any surprise charges in writing rather than paying immediately.