Blood test, PSA (prostate screen)
Facility: Stanton County Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $135
- Cash Discount Price: $116
- vs. Medicare Baseline: 7.34x 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 734% of the Medicare baseline (a markup of 634%). 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 - $230 | 353% |
| Healthy Blue Mcr Adv - All Other Plans | $134 - $238 | 729% |
| Healthy Blue Mcaid | $136 - $207 | 740% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) at Stanton County Hospital in Johnson, KS, the cash price is $116.00, which matches the facility's median negotiated rate. This cash price is significantly lower than the Medicare benchmark of $18.39, indicating a substantial markup relative to the federal government's fixed reimbursement rate. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance plans often negotiate rates that can exceed the cash price. For instance, the lowest negotiated rate among the three in-network payers is $134, which is higher than the cash amount. Consequently, individuals with high-deductible plans or those without insurance may find paying the $116.00 cash price more cost-effective than relying on insurance, provided they qualify for the cash rate.
To minimize out-of-pocket costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. It is also important to verify your specific insurance plan's allowed amount before scheduling, as in-network rates vary significantly between carriers and can sometimes be higher than the cash price. Although the facility is in-network for three payers, the data shows no county or state average figures provided for comparison, so the decision to use insurance versus cash depends entirely on your individual deductible status and the specific negotiated rates of your plan. Always request an itemized bill to ensure all charges are accurate and to identify any potential errors before finalizing payment.