Blood test, PSA (prostate screen)
Facility: Scott County Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $201
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 10.93x 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 1093% of the Medicare baseline (a markup of 993%). 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 | $18 - $212 | 98% |
| Blue Cross Blue Shield | $68 | 370% |
| Humana | $94 | 511% |
| Wppa | $134 - $1,200 | 729% |
| Aetna | $201 | 1093% |
Consumer Guidance & Cost Commentary
For the CPT code 84153, representing a prostate-specific antigen (PSA) blood test, Scott County Hospital in Scott City, KS, lists a gross charge of $223.00. This amount is significantly higher than the Medicare benchmark of $18.39, which serves as the federal baseline for this service. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates vary widely among payers; for instance, UnitedHealthcare plans range from $18 to $212, whereas WPPA plans can reach up to $1,200. It is important to note that these negotiated rates often exceed cash prices due to administrative overhead and contract dynamics, meaning patients with high-deductible plans might find paying out-of-pocket cheaper if the facility offers a self-pay or prompt-pay discount.
When evaluating costs against regional standards, the facility's pricing context is defined by its location in Scott County, KS. Although specific county or state average data for this procedure was not provided in the source information, the wide variance in payer negotiations—ranging from a flat $68 with Blue Cross Blue Shield and Humana to a maximum of $1,200 with WPPA—highlights the importance of verifying your specific plan's allowed amount before scheduling. To minimize financial exposure, patients should request an itemized bill to ensure no unbundled codes or services not rendered are included, and they should explicitly ask about prompt-pay discounts or self-pay rates prior to check-in. Since over 80% of hospital bills contain errors, obtaining a detailed line-by-line statement is the most effective step to identify potential overcharges and negotiate