Blood test, PSA (prostate screen)
Facility: Hospital District #6 Patterson Health Center
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $131
- Cash Discount Price: $116
- vs. Medicare Baseline: 7.12x 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 712% of the Medicare baseline (a markup of 612%). 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 | $64 - $67 | 348% |
| UnitedHealthcare | $130 - $145 | 707% |
| Providers Care (Wppa)-All Plans | $254 | 1381% |
Consumer Guidance & Cost Commentary
For the prostate screening test (CPT 84153) at the Hospital District #6 Patterson Health Center in Anthony, KS, the facility's negotiated rates range from $64 to $254 depending on your specific insurance plan. While the median negotiated amount is $131, the cash price is $116, meaning self-pay patients may save money by paying directly rather than using insurance. It is important to note that commercial insurance rates often include administrative overhead and contract markups, which can make them higher than the cash price even for in-network members. To maximize savings, patients should verify their specific plan's allowed amount before scheduling and ask the hospital about "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront.
This service is priced significantly higher than the state average, with the facility's cash rate of $116 compared to a state median of $18.39 for Medicare, reflecting the typical markup found in commercial billing. The facility's ownership by a government hospital district does not automatically guarantee lower rates, as negotiated contracts vary widely among payers. Consumers should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under federal law, but unexpected charges can still occur if ancillary services are out-of-network. If you receive a bill, request a full itemized statement to review every code and unit charge, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.