Blood test, PSA (prostate screen)
Facility: Logan County Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $172
- Cash Discount Price: $50
- vs. Medicare Baseline: 9.35x 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 935% of the Medicare baseline (a markup of 835%). 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% |
| Humana | $106 | 576% |
| Health Partners - All Plans | $238 | 1294% |
| Medicaid / KanCare | $250 | 1359% |
Consumer Guidance & Cost Commentary
For the CPT code 84153 (Blood test, PSA), Logan County Hospital in Oakley, KS, lists a cash median price of $50.00, which is significantly lower than the facility's negotiated rates of $172.00 paid by insurers like Blue Cross Blue Shield and Humana. This price difference highlights a common billing dynamic where commercial insurance contracts often exceed cash-pay options; for patients with high-deductible plans, paying the $50.00 cash rate directly can result in substantial savings compared to the $172.00 allowed amount. While the facility is a Critical Access Hospital owned by the local government, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can further reduce the final cost.
When evaluating this charge against broader benchmarks, it is important to compare rates to the Medicare baseline rather than the hospital's inflated gross charges. The Medicare amount for this service is $18.39, and the facility's cash rate of $50.00 represents a markup of 9.4 times the Medicare rate, which aligns with typical commercial pricing structures where negotiated rates average 200% to 300% of Medicare. Consumers should be aware that hospitals often issue summary bills that obscure individual line items, so requesting a full itemized statement is crucial to identifying any unbundled codes or services not rendered. By understanding that the $172.00 negotiated rate includes administrative overhead and contract dynamics, patients can make informed decisions about whether to use insurance or pay out-of-pocket.