Blood test, PSA (prostate screen)
Facility: Stevens County Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $128
- Cash Discount Price: $231
- vs. Medicare Baseline: 6.96x 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 696% of the Medicare baseline (a markup of 596%). 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 |
|---|---|---|
| Aetna | $28 - $308 | 152% |
| Humana | $57 - $114 | 310% |
| Blue Cross Blue Shield | $65 - $68 | 353% |
| First Health - All Plans | $139 - $277 | 756% |
| Wppa - All Plans | $146 - $293 | 794% |
| Medicaid / KanCare | $154 - $308 | 837% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Stevens County Hospital in Hugoton, Kansas, the cash price is $231.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state average for this service, which is $18.39. While commercial insurance plans like Aetna and Medicaid/KanCare negotiate rates ranging from $28 to $308, these negotiated amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the $231.00 cash price directly, as this avoids the administrative fees and potential higher negotiated rates that insurance companies apply. To secure the best possible rate, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill.
It is important to understand that the $231.00 cash price is not the same as the hospital's full chargemaster list price, which is often inflated to make discounts appear larger. If you choose to use insurance, be aware that the facility may bill you for the difference between their full charge and what the insurer pays, a practice known as balance billing, though the No Surprises Act protects you from such surprise bills for emergency care and non-emergency services at in-network facilities. Furthermore, if you receive a summary bill, you should request a full itemized audit to ensure no errors, unbundled codes, or services not rendered are included, as over 80% of hospital bills contain mistakes. By comparing the facility's rates directly to the Medicare benchmark of $18.39 and verifying your