Blood test, PSA (prostate screen)
Facility: Fredonia Regional Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $80
- Cash Discount Price: $88
- vs. Medicare Baseline: 4.35x 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 435% of the Medicare baseline (a markup of 335%). 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 | $16 - $80 | 87% |
| Blue Cross Blue Shield | $44 - $68 | 239% |
| Aetna | $45 - $80 | 245% |
| Veterans Programs - All Plans | $45 | 245% |
| Meritain-All Plans | $80 | 435% |
| Cigna | $80 | 435% |
| Reserve National-All Plans | $80 | 435% |
Consumer Guidance & Cost Commentary
For this blood test, PSA (prostate screen) at Fredonia Regional Hospital in Kansas, the cash price is $88.00, which matches the facility's negotiated rate of $80.00 and the median paid amount. While the facility is a Critical Access Hospital with government ownership, the cash price is notably higher than the Medicare benchmark of $18.39, reflecting a significant markup common in commercial billing. Patients with high-deductible plans might find paying the full cash price of $88.00 more affordable than using insurance, as the negotiated rate of $80.00 often exceeds the cash price when administrative fees and claim processing costs are factored in. It is important to verify your specific plan's deductible status before scheduling, as paying out-of-pocket could save you money if your insurance would otherwise cover a higher allowed amount.
When comparing this service to regional standards, the cash price of $88.00 is substantially higher than the state average for similar procedures, though specific county averages were not provided in the data. The facility offers a wide range of payer rates, with UnitedHealthcare ranging from $16 to $80 and Blue Cross Blue Shield from $44 to $68, indicating that the final cost depends heavily on your specific insurance contract. To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before check-in, as these upfront payment incentives can reduce the final bill by 20% to 50%. If you receive a bill after using insurance, do not immediately pay it; instead, request a full itemized audit to identify any errors, unbundled codes, or services