Blood test, PSA (prostate screen)
Facility: Clara Barton Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $86
- Cash Discount Price: $95
- vs. Medicare Baseline: 4.68x 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 468% of the Medicare baseline (a markup of 368%). 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 |
|---|---|---|
| 6 Degrees Health - All Plans | $65 - $124 | 353% |
| Blue Cross Blue Shield | $67 | 364% |
| Wppa-All Plans | $74 - $142 | 402% |
| Aetna | $84 - $159 | 457% |
| UnitedHealthcare | $84 - $159 | 457% |
| Phcs - All Plans | $84 - $159 | 457% |
| Hlth Partners Of Ks-All Plans | $86 - $163 | 468% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Clara Barton Hospital in Hoisington, KS, the cash median price is $95.00, while the median negotiated rate paid by insurance is $85.00. This specific service is priced at 4.7 times the Medicare benchmark amount of $18.39. For patients with high-deductible plans, paying the cash price of $95.00 may be more cost-effective than relying on insurance, as the negotiated rate of $85.00 could still result in significant out-of-pocket costs if the patient has not yet met their deductible. It is important to verify your specific plan's allowed amount before scheduling, as in-network rates vary significantly between payers.
Facility pricing data shows that the cash median of $95.00 is lower than the state average for this procedure, though specific county averages were not provided in this report. The facility offers a voluntary non-profit status and is a Critical Access Hospital located at 250 W 9Th Street. Patients should proactively request a full itemized billing audit before finalizing payment, as summary bills often obscure individual charges and potential errors. Additionally, asking about prompt-pay discounts prior to check-in can help reduce the final bill, as hospitals often offer fee reductions for upfront payments to bypass costly claims processing.