Blood test, PSA (prostate screen)
Facility: Sheridan County Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $94
- Cash Discount Price: $141
- vs. Medicare Baseline: 5.11x 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 511% of the Medicare baseline (a markup of 411%). 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 |
|---|---|---|
| Celtic Insurance | $85 | 462% |
| Blue Cross Blue Shield | $94 | 511% |
| UnitedHealthcare | $134 | 729% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Sheridan County Hospital in Hoxie, KS, the cash price is $141.00, which matches the facility's median negotiated rate of $94.00. This cash price is 5.1 times higher than the Medicare benchmark of $18.39, indicating a significant markup relative to the federal cost baseline. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find the cash price more affordable than their insurance negotiated rate, which could exceed $141.00 depending on the specific plan. It is important to verify your deductible status before scheduling, as paying out-of-pocket might result in lower immediate costs if your insurance has not yet covered the service.
To minimize potential costs, patients should contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can range from 20% to 50% off the billed amount for upfront payments. Although the data shows a single payer rate of $94.00 for Blue Cross Blue Shield, commercial insurance contracts often include administrative overhead that can inflate the final charge, so asking for a cash discount before check-in is a critical step. Additionally, since over 80% of hospital bills contain errors, patients should request a detailed, itemized statement rather than accepting a summary bill, and they should dispute any discrepancies in writing to ensure accuracy.