Blood test, PSA (prostate screen)
Facility: Hiawatha Community Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $168
- Cash Discount Price: $219
- vs. Medicare Baseline: 9.14x 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 914% of the Medicare baseline (a markup of 814%). 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 | $65 - $68 | 353% |
| Aetna | $67 - $206 | 364% |
| UnitedHealthcare | $67 - $219 | 364% |
| Humana | $68 - $95 | 370% |
| Ambetter / Centene | $81 - $113 | 440% |
| Centrus Health Direct - All Plans | $136 - $191 | 740% |
| Oscar - All Plans | $136 - $191 | 740% |
| Preferred Hlth - All Plans | $164 - $230 | 892% |
| Wppa Providrs Care - All Plans | $173 - $242 | 941% |
| Cigna | $173 - $242 | 941% |
| Multiplan - All Plans | $177 - $247 | 962% |
| Midlands Choice - All Plans | $177 - $247 | 962% |
| Healthy Blue Mcaid - All Plans | $182 - $255 | 990% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Hiawatha Community Hospital, the cash price is $219.00, which matches the facility's cash median. This cash rate is significantly higher than the state of Kansas average, which is $168.00. While commercial insurance plans like Aetna, UnitedHealthcare, and Humana negotiate rates ranging from $65 to $255, these negotiated amounts often exceed the cash price. Patients with high-deductible plans or those without insurance may find it financially advantageous to pay the $219.00 cash price directly, as it is lower than many of the in-network negotiated rates listed for this facility.
To ensure you are receiving the most accurate pricing, it is important to understand that hospitals often offer prompt-pay discounts for self-pay patients who settle their bill upfront. Since the cash median of $219.00 is already above the state average, verifying if a "self-pay" or "prompt-pay" discount is available could further reduce your cost. Additionally, if you are using insurance, be aware that the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network facilities, meaning you should not be billed for the difference between the hospital's full charge and your insurance allowed amount. Always request an itemized bill to review specific CPT codes and avoid unexpected charges for services not rendered or unbundled components.