Blood test, PSA (prostate screen)
Facility: Hodgeman County Health Center
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $122
- Cash Discount Price: $130
- vs. Medicare Baseline: 6.63x 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 663% of the Medicare baseline (a markup of 563%). 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 | $65 - $68 | 353% |
| Humana | $102 - $106 | 555% |
| Medicaid / KanCare | $102 - $165 | 555% |
| UnitedHealthcare | $102 - $157 | 555% |
| Triwest - All Plans | $102 - $106 | 555% |
| Aetna | $127 - $132 | 691% |
| First Health - All Plans | $143 - $148 | 778% |
| Wppa (Provdrscare) - All Plans | $151 - $157 | 821% |
| Health Partners - All Plans | $151 - $157 | 821% |
Consumer Guidance & Cost Commentary
For the CPT code 84153, representing a prostate-specific antigen (PSA) blood test, Hodgeman County Health Center in Jetmore, Kansas, lists a gross charge of $162.00. The facility's cash median rate is $130.00, which is lower than the negotiated rates paid by most commercial payers, ranging from $102.00 to $165.00. This pricing structure highlights a common billing dynamic where commercial insurance contracts often exceed cash prices due to administrative overhead and network tiering. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $130.00 directly may result in lower total costs compared to the insurance negotiated rate, provided the patient can afford the upfront payment.
The facility's negotiated rates are significantly higher than the Medicare benchmark of $18.39, with the cash median of $130.00 representing a substantial markup relative to the federal baseline. While the facility is a government-owned Critical Access Hospital, patients should verify their specific plan details before scheduling, as some in-network contracts may still result in higher out-of-pocket costs than self-pay. To potentially reduce the final bill, patients are encouraged to contact the billing department directly to inquire about "self-pay" or "prompt-pay" discounts, which can offer immediate fee reductions for upfront payment. Additionally, requesting a detailed, itemized bill is essential to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal audit dispute.