Blood test, PSA (prostate screen)
Facility: Minneola District Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $91
- Cash Discount Price: $79
- vs. Medicare Baseline: 4.95x 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 495% of the Medicare baseline (a markup of 395%). 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 | $64 - $130 | 348% |
| Va Community Care Program-All Plans | $64 - $87 | 348% |
| Humana | $64 - $87 | 348% |
| Blue Cross Blue Shield | $68 | 370% |
| Providrs Care Network-All Plans | $82 - $110 | 446% |
| Corporate Plan Management-All Plans | $82 - $110 | 446% |
| Triwest-All Plans | $86 - $117 | 468% |
| Preferred Health Care (Coventry)-All Other Plans | $86 - $117 | 468% |
| Phc (Coventry) Leased Network | $91 - $124 | 495% |
| Aetna | $91 - $130 | 495% |
| Health Partners Of Kansas-All Plans | $91 - $124 | 495% |
| Medicaid / KanCare | $96 - $130 | 522% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Minneola District Hospital, the cash median price is $79.00, which is lower than the facility's negotiated rate of $91.00. This cash price is also notably lower than the gross charge of $113.00. While the facility is a Critical Access Hospital in Kansas, the data provided does not include specific county or state average figures for this procedure, so a direct comparison to regional averages cannot be made based on the available information. Patients with high-deductible plans may find that paying the cash price of $79.00 upfront is more cost-effective than relying on insurance, as the negotiated rate of $91.00 exceeds the cash amount.
The Medicare amount for this service is $18.39, which serves as a benchmark for the true cost of care. The facility's negotiated rate of $91.00 represents a significant markup compared to the Medicare rate, illustrating how commercial contracts can inflate prices beyond the federal baseline. To ensure you are receiving the best possible rate, it is recommended to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the bill. Additionally, if you receive an itemized bill, review it carefully to ensure no errors exist, such as unbundled codes or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through a formal audit dispute.