Blood test, PSA (prostate screen)
Facility: Memorial Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $99
- Cash Discount Price: $180
- vs. Medicare Baseline: 5.38x 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 538% of the Medicare baseline (a markup of 438%). 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 | $48 | 261% |
| Humana | $90 | 489% |
| Tricare | $90 | 489% |
| Medicare (plans) | $91 | 495% |
| Ambetter / Centene | $99 | 538% |
| Coventry - All Other Plans | $162 | 881% |
| Health Partners Of Kansas - All Plans | $171 | 930% |
| Preferred Healthcare-All Plans | $171 | 930% |
| Wppa/Providers Care-All Plans | $252 | 1370% |
Consumer Guidance & Cost Commentary
For the CPT code 84153 (Blood test, PSA), Memorial Hospital in Abilene, KS, lists a cash price of $180.00, which matches the facility's median negotiated rate of $91.00. While the facility is a Critical Access Hospital with a government ownership structure, the cash price is notably higher than the median negotiated rate of $99.00 observed across the nine payers in this dataset. Patients with high-deductible plans may find the cash price of $180.00 more affordable than the commercial negotiated rates, which range from $48.00 for Blue Cross Blue Shield to $252.00 for Wppa/Providers Care. It is important to note that while the facility's cash price is $180.00, the Medicare benchmark for this service is significantly lower at $18.39, indicating that commercial rates often exceed the federal baseline by a wide margin.
To ensure you are receiving the most accurate pricing, always request an itemized bill before finalizing payment, as summary bills can obscure individual charges and potential errors. If you choose to pay out-of-pocket, ask specifically about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if settled upfront. Furthermore, be aware that while the facility is in-network for most major payers, the No Surprises Act protects you from balance billing for out-of-network services at this in-network Critical Access Hospital. Always verify your specific plan's deductible status and allowed amounts with the hospital prior to scheduling to avoid unexpected costs.