Blood test, PSA (prostate screen)
Facility: Lindsborg Community Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $165
- Cash Discount Price: $126
- vs. Medicare Baseline: 8.97x 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 897% of the Medicare baseline (a markup of 797%). 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 | $67 | 364% |
| Tricare | $85 | 462% |
| Coventry Mcr Adv | $86 | 468% |
| Cigna | $153 | 832% |
| UnitedHealthcare | $162 | 881% |
| Coventry Comm-All Other Plans | $162 | 881% |
| Phcs Preferred-All Plans | $168 | 914% |
| Multiplan-All Plans | $168 | 914% |
| Health Partners -All Plans | $171 | 930% |
| Century Health-All Plans | $171 | 930% |
| Wppa-All Plans | $171 | 930% |
| Coventry Wc | $171 | 930% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Lindsborg Community Hospital, the facility's cash price of $126.00 is notably lower than the median negotiated rate of $168.00 and the gross charge of $180.00. While the facility is a Critical Access Hospital in Lindsborg, KS, with a voluntary non-profit ownership structure, patients should be aware that commercial insurance carriers typically pay negotiated rates that exceed cash prices due to administrative overhead and contract dynamics. In this case, the cash price is $52.00 less than the median negotiated amount, which could result in significant savings for patients with high-deductible plans who have not yet met their coverage thresholds. It is important to verify your specific plan's allowed amount before scheduling, as in-network rates can vary significantly between payers, with some commercial plans paying as low as $67.00 while others pay up to $171.00 for this service.
To maximize potential savings, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before check-in, as hospitals often offer fee reductions of 20% to 50% for upfront payments that bypass costly insurance billing cycles. Additionally, since over 80% of hospital bills contain errors, requesting a detailed, itemized statement is crucial to identify any unbundled codes or services not rendered before finalizing payment. While Medicare serves as a benchmark for fair pricing, the commercial rates observed here reflect standard market negotiations rather than the federal baseline; however, the substantial difference between the cash price and the insurance negotiated rates highlights the value of understanding your deductible status and payment options. Always