Blood test, PSA (prostate screen)
Facility: Kiowa County Memorial Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $125
- Cash Discount Price: $115
- vs. Medicare Baseline: 6.80x 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 680% of the Medicare baseline (a markup of 580%). 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 - $125 | 370% |
| UnitedHealthcare | $103 - $141 | 560% |
| Health Partners Of Ks-All Plans | $114 - $124 | 620% |
| Medica Prime Mcare Cost-All Plans | $115 - $125 | 625% |
| Aetna | $115 - $125 | 625% |
| Celtic Comml Exchange-All Other Plans | $115 - $125 | 625% |
| Humana | $115 - $125 | 625% |
| Medicaid / KanCare | $129 - $141 | 701% |
| Providrs Care/Wppa-All Plans | $194 - $212 | 1055% |
Consumer Guidance & Cost Commentary
For the CPT code 84153 (Blood test, PSA), Kiowa County Memorial Hospital in Greensburg, KS, lists a cash median price of $115.00, which aligns with the facility's median negotiated rate of $125.00. This cash price is notably lower than the gross charge of $135.00 and sits below the state average for this service. While commercial payers like UnitedHealthcare and Medicaid/KanCare have negotiated rates ranging from $103 to $212, patients with high-deductible plans may find paying the $115 cash price directly more cost-effective than relying on insurance, especially if their allowed amount exceeds the cash rate. It is important to note that while the facility is a Critical Access Hospital with government-local ownership, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final bill by bypassing administrative claim processing fees.
The Medicare benchmark for this procedure is $18.39, which serves as a critical baseline for evaluating the facility's pricing markup. The cash price of $115.00 represents a significant increase over the Medicare rate, reflecting the costs of local labor and facility operations, but it remains well below the gross chargemaster list price. Patients should be aware that commercial negotiated rates often include administrative overheads that can inflate the baseline price by 20% to 40% compared to pure service costs. If a patient receives a bill that includes charges for services not rendered or unbundled components, they should request a full itemized audit to identify errors, as over 8