Blood test, PSA (prostate screen)
Facility: Kiowa District Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $141
- Cash Discount Price: $128
- vs. Medicare Baseline: 7.67x 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 767% of the Medicare baseline (a markup of 667%). 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 |
|---|---|---|
| Healthchoice-All Plans | $28 | 152% |
| Tricare | $52 - $73 | 283% |
| Blue Cross Blue Shield | $67 | 364% |
| UnitedHealthcare | $106 - $187 | 576% |
| Health Partners Of Ks-All Plans | $117 - $165 | 636% |
| Humana | $120 - $169 | 653% |
| Gbs Insurance - All Plans | $125 - $176 | 680% |
| Multiplan-All Plans | $125 - $176 | 680% |
| Triwest-All Plans | $126 - $178 | 685% |
| Aetna | $126 - $178 | 685% |
| Medicare (plans) | $126 - $178 | 685% |
| Medicaid / KanCare | $133 - $187 | 723% |
| Providers Care (Wppa)-All Plans | $200 - $280 | 1088% |
| Liberty Healthshare-All Plans | $215 - $302 | 1169% |
Consumer Guidance & Cost Commentary
For the CPT code 84153 (Blood test, PSA), Kiowa District Hospital in Kiowa, KS, lists a gross charge of $160.00. While the facility offers a cash median price of $128.00 and a median negotiated rate of $141.00, these figures are significantly higher than the Medicare benchmark of $18.39. Under federal protections like the No Surprises Act, patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities, though unexpected ancillary charges can sometimes occur. If you have a high-deductible plan, paying the cash price of $128.00 upfront might be more cost-effective than your insurance applying a negotiated rate that exceeds this amount, provided you secure a prompt-pay discount before the claim is submitted.
It is important to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Since the facility is a Critical Access Hospital owned by a Government Hospital District, you should verify whether your specific plan is in-network to avoid potential balance billing issues. If you choose to pay out-of-pocket, ask the billing department about self-pay or prompt-pay discounts, which can reduce the cost by 20% to 50% if settled within 30 days. Always ensure you receive a full, CPT-coded itemized statement rather than a summary bill, and dispute any discrepancies in writing to protect your rights and prevent unnecessary debt.