Blood test, PSA (prostate screen)
Facility: Greenwood County Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $87
- Cash Discount Price: $82
- vs. Medicare Baseline: 4.73x 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 473% of the Medicare baseline (a markup of 373%). 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 |
|---|---|---|
| UnitedHealthcare | $19 - $87 | 103% |
| Triwest - All Plans | $37 | 201% |
| Tricare | $43 | 234% |
| Choicecare Mcr Adv - All Plans | $43 | 234% |
| Blue Cross Blue Shield | $64 - $67 | 348% |
| Integrated Health Plan - All Plans | $77 | 419% |
| Beech Street - All Plans | $88 | 479% |
| First Health Ccn Network | $88 | 479% |
| First Health - All Other Plans | $88 | 479% |
| Preferred Hs (Coventry) - All Plans | $93 | 506% |
| Principal Health Care Inc - All Plans | $98 | 533% |
| Amerigroup Mcaid-All Plans | $103 | 560% |
| Medicaid / KanCare | $103 | 560% |
| Providrs Care/Wppa - All Plans | $154 | 837% |
Consumer Guidance & Cost Commentary
For the prostate screening service (CPT 84153) at Greenwood County Hospital in Eureka, Kansas, the facility's cash price of $82.00 is lower than the state average of $87.00 and the median negotiated rate of $87.00. While many major payers, including UnitedHealthcare and Triwest, have negotiated rates ranging from $19 to $87, patients with high-deductible plans may find the cash price more advantageous if their insurance allowed amount exceeds $82.00. Because prompt-pay discounts can reduce bills by 20% to 50%, it is advisable to ask the hospital about self-pay or prompt-pay rates before scheduling, ensuring the billing system is set to classify the service as self-pay rather than submitting a claim to insurance.
The facility's Medicare benchmark rate of $18.39 serves as the objective baseline for evaluating pricing, revealing that commercial rates are significantly higher than the federal cost basis. Although the facility is a Critical Access Hospital owned by the local government, the wide variation in payer rates—from $19 for UnitedHealthcare to $154 for Providrs Care/Wppa—highlights the importance of verifying your specific plan's allowed amount. To avoid unexpected balance billing, patients should request an itemized bill before paying, as summary invoices can obscure individual charges, and should dispute any discrepancies in writing rather than accepting verbal assurances.