Blood test, PSA (prostate screen)
Facility: Morris County Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $67
- Cash Discount Price: $103
- vs. Medicare Baseline: 3.64x 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 364% of the Medicare baseline (a markup of 264%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $18 | 98% |
| Aetna | $23 | 125% |
| Va Ccn-All Plans | $32 | 174% |
| Blue Cross Blue Shield | $65 - $68 | 353% |
| Coventry Mcr | $67 | 364% |
| Choice Care Mcr Adv-All Plans | $67 | 364% |
| UnitedHealthcare | $67 - $172 | 364% |
| Cigna | $124 | 674% |
| Coventry Comm-All Other Plans | $155 | 843% |
| Multiplan-All Plans | $155 | 843% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Morris County Hospital in Council Grove, Kansas, the cash median price is $103.00, while the median negotiated rate paid by insurance is $67.00. This data reflects a specific CPT code (84153) with a gross charge of $172.00. Patients should be aware that while insurance negotiated rates can be lower than cash prices, paying out-of-pocket upfront may sometimes result in a lower total cost if the patient's insurance deductible has not yet been met or if the negotiated rate exceeds the cash price. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling the test, as these incentives can reduce the final amount owed.
The facility is a Critical Access Hospital with government-local ownership, and the data indicates a Medicare benchmark of $18.39. When comparing commercial rates to this federal baseline, the cash price of $103.00 represents a significant markup relative to the Medicare amount. While the provided dataset does not include specific state or county average figures for this procedure, the wide variation in negotiated rates among payers—ranging from $18 for some plans to $172 for others—highlights the importance of verifying your specific plan's allowed amount. Consumers are encouraged to request an itemized bill to ensure no errors exist, as over 80% of hospital bills contain discrepancies such as unbundled codes or services not rendered. If a balance bill arises from an out-of-network situation, patients should dispute the charge with their insurer rather than paying immediately, as federal protections like the No