Blood test, PSA (prostate screen)
Facility: Wilson Medical Center
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $71
- Cash Discount Price: $83
- vs. Medicare Baseline: 3.86x 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 386% of the Medicare baseline (a markup of 286%). 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 | $6 - $125 | 33% |
| Ambetter / Centene | $6 - $134 | 33% |
| Tricare | $6 - $71 | 33% |
| Aetna | $6 - $134 | 33% |
| Humana | $6 - $71 | 33% |
| Cigna | $10 - $107 | 54% |
| Mulitplan-All Plans | $11 - $123 | 60% |
| Health Partners-All Plans | $11 - $123 | 60% |
| Blue Cross Blue Shield | $12 - $134 | 65% |
Consumer Guidance & Cost Commentary
For the CPT code 84153, representing a prostate-specific antigen (PSA) blood test, Wilson Medical Center in Neodesha, KS, lists a gross charge of $111.00. This facility, a Critical Access Hospital owned by the local government, has a cash median price of $83.00 and a median negotiated rate of $71.00 across nine payers. These figures are notably lower than the state average, which sits at $18.39 for Medicare and generally higher for commercial plans due to administrative overhead. While the facility's negotiated rates are competitive, patients should note that cash payments can sometimes be more cost-effective than insurance claims, particularly for those with high-deductible plans where the insurer's allowed amount might exceed the cash price.
To maximize savings, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payments. It is important to request a waiver of insurance submission before check-in to avoid automatic claims processing that could void these cash agreements. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should always request a detailed, itemized bill rather than accepting a summary invoice. Comparing the facility's rates to the Medicare benchmark of $18.39 reveals that commercial negotiated rates often include significant markups for administrative processing, making it essential to review the specific allowed amounts for your plan rather than assuming in-network status guarantees the lowest possible price.