Blood test, PSA (prostate screen)
Facility: Osborne County Memorial Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $97
- Cash Discount Price: $96
- vs. Medicare Baseline: 5.27x 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 527% of the Medicare baseline (a markup of 427%). 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 |
|---|---|---|
| UnitedHealthcare | $76 - $96 | 413% |
| Health Partners Of Kansas | $86 - $108 | 468% |
| Wppa | $95 - $120 | 517% |
| Blue Cross Blue Shield | $98 - $123 | 533% |
Consumer Guidance & Cost Commentary
For the CPT code 84153 (Blood test, PSA), Osborne County Memorial Hospital in Osborne, KS, lists a cash median price of $96.00, which is $17.00 lower than the facility's gross charge of $113.00. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead. For instance, UnitedHealthcare's negotiated range is $76.00 to $96.00, while Wppa's range is $95.00 to $120.00. In this specific case, the cash price is competitive, but patients with high-deductible plans might find paying the cash median of $96.00 upfront more cost-effective than facing a negotiated rate that could exceed their deductible, provided they secure a "waiver of insurance submission" to avoid automatic claims processing.
The facility's cash rate of $96.00 is notably higher than the Medicare amount of $18.39, reflecting the standard markup for commercial services, though it remains below the gross charge. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network emergency services at in-network facilities, patients should still request a detailed, itemized bill to verify that no unbundled codes or services not rendered have been charged. If you receive a summary bill, you should demand a line-by-line CPT-coded statement to identify any errors before payment. Additionally, since the facility offers prompt-pay discounts for upfront payment, you should contact the billing department before scheduling to