Blood test, PSA (prostate screen)
Facility: Norton County Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $95
- Cash Discount Price: $95
- vs. Medicare Baseline: 5.17x 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 517% of the Medicare baseline (a markup of 417%). 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 | $95 | 517% |
Consumer Guidance & Cost Commentary
For this blood test at Norton County Hospital, the cash price of $95 is significantly lower than the facility's negotiated rate of $95, which matches the state average for this service. While the facility is a Critical Access Hospital in Norton, KS, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rate often exceeds the cash price due to administrative overhead. To ensure you receive the best possible rate, it is recommended to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed before any insurance claim is processed.
This service is benchmarked against Medicare, which pays $18.39 for this procedure, highlighting the substantial markup inherent in commercial billing. Although the data indicates a single payer, Blue Cross Blue Shield, with a negotiated rate of $95, patients should be aware that balance billing is generally prohibited for in-network services under the No Surprises Act, protecting you from unexpected charges beyond your deductible. If you receive a bill that appears to include charges for services not rendered or items that were cancelled, you have the right to request a formal itemized audit to identify errors before making any payment.