Blood test, PSA (prostate screen)
Facility: Lincoln County Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $68
- Cash Discount Price: $85
- vs. Medicare Baseline: 3.70x 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 370% of the Medicare baseline (a markup of 270%). 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 | $68 | 370% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Lincoln County Hospital in Lincoln, KS, the cash median price is $85.00, which is lower than the facility's negotiated rate of $68.00 and the Medicare benchmark of $18.39. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that cash payments can sometimes be more cost-effective than using insurance if the negotiated rate exceeds the cash price. Because this service is billed at a specific CPT code, patients with high-deductible plans may find it beneficial to pay the cash median directly, provided they confirm the facility offers a self-pay or prompt-pay discount to further reduce the amount owed.
It is important to distinguish between the facility's gross charge of $95.00 and the actual amounts paid or negotiated. The gross charge represents the full list price, but the negotiated rate of $68.00 reflects the contractually agreed-upon amount with Blue Cross Blue Shield, which is the only payer listed for this service. Since the negotiated rate is higher than the cash price, patients should explicitly ask the hospital to classify the account as self-pay before scheduling to avoid being billed the full gross amount. Additionally, if a patient receives an itemized bill that includes unexpected charges or uses a summary bill instead of a detailed statement, they should request a formal itemized audit to ensure all services rendered are accurately coded and no balance billing occurs, especially given federal protections against surprise bills for out-of-network ancillary services.