Blood test, PSA (prostate screen)
Facility: Stafford County Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $119
- Cash Discount Price: $132
- vs. Medicare Baseline: 6.47x 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 647% of the Medicare baseline (a markup of 547%). 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 |
|---|---|---|
| Va Ccn-All Plans | $22 - $24 | 120% |
| UnitedHealthcare | $22 - $24 | 120% |
| Health Partners-All Plans | $113 - $125 | 614% |
| Medica Mcr- All Plans | $119 - $132 | 647% |
| Humana | $119 - $132 | 647% |
Consumer Guidance & Cost Commentary
For the prostate screening service (CPT 84153) at Stafford County Hospital, the cash price is $132.00, which matches the facility's median negotiated rate of $125.00. This cash price is notably higher than the state average for this procedure, which is $119.00. While commercial insurance plans like UnitedHealthcare and Va Ccn-All Plans have negotiated rates between $22.00 and $24.00, these figures are significantly lower than the cash price and represent the maximum amounts insurers will pay under contract. Patients with high-deductible plans should be aware that paying the cash price of $132.00 upfront may be more cost-effective than using insurance, as the insurer's allowed amount often exceeds the cash rate, potentially leaving the patient responsible for the difference after their deductible is met.
The facility, a Critical Access Hospital in Stafford, KS, operates under a government-local ownership model, and its pricing is benchmarked against Medicare, which sets the rate at $18.39 for this service. The facility's cash price is 6.5 times the Medicare amount, reflecting the standard markup seen in commercial pricing. To minimize costs, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the bill by 20% to 50% by bypassing administrative fees associated with insurance claims. Additionally, since over 80% of hospital bills contain errors, it is advisable to request a full itemized statement to verify that all charges are accurate and that no services were unbundled or billed twice.