Blood test, PSA (prostate screen)
Facility: Mitchell County Hospital Health Systems
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $110
- Cash Discount Price: $106
- vs. Medicare Baseline: 5.98x 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 598% of the Medicare baseline (a markup of 498%). 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 - $124 | 98% |
| Blue Cross Blue Shield | $68 | 370% |
| Triwest Well Mark All Plans | $94 - $105 | 511% |
| First Health-All Plans | $100 - $112 | 544% |
| Aetna | $100 - $112 | 544% |
| Pref Hlth Care Sytms Comm - All Plans | $100 - $112 | 544% |
| Multiplan Ppo - All Plans | $105 - $118 | 571% |
| Auxiant-All Plans | $105 - $118 | 571% |
| Phc Leased Ntwrk Access - All Plans | $105 - $118 | 571% |
| Health Partners Ks-All Plans | $110 - $123 | 598% |
| Cigna | $110 - $123 | 598% |
Consumer Guidance & Cost Commentary
For this blood test, PSA (prostate screen) at Mitchell County Hospital Health Systems in Beloit, KS, the facility's cash price is $106.00, while the median negotiated rate paid by insurance plans is $110.00. This test is billed under CPT code 84153, and the facility's cash price is slightly lower than the median negotiated amount, which is a common occurrence when commercial contracts include administrative overheads that inflate the baseline price. The facility's cash price is also 6.0% higher than the Medicare benchmark of $18.39, reflecting the standard markup structure for this service. Patients with high-deductible plans may find it beneficial to pay the cash price directly, as it avoids the administrative costs embedded in the negotiated rate, provided they have not yet met their deductible.
The facility is a Critical Access Hospital owned by the local government, and while the specific county or state average for this procedure is not provided in the data, patients should be aware that in-network rates can vary significantly even within the same system. It is important to verify the exact allowed amount with your specific insurance plan before scheduling, as some in-network facilities may charge higher negotiated rates than others. Additionally, patients should ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront, bypassing the costly claims processing cycle. If you receive a bill, always request a full itemized statement to ensure no errors exist before making a payment.