Blood test, PSA (prostate screen)
Facility: Amberwell Atchison Association
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $100
- Cash Discount Price: $219
- vs. Medicare Baseline: 5.44x 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 544% of the Medicare baseline (a markup of 444%). 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 | $54 - $458 | 294% |
| Va Ccn - All Plans | $60 - $84 | 326% |
| Humana | $60 - $115 | 326% |
| Superior Select Mcr Adv - All Plans | $60 - $84 | 326% |
| Triwest - All Plans | $60 - $84 | 326% |
| Blue Cross Blue Shield | $65 - $68 | 353% |
| Ambetter / Centene | $93 - $130 | 506% |
| Aetna | $100 - $140 | 544% |
| Cigna | $100 - $140 | 544% |
| Oscar - All Plans | $136 - $191 | 740% |
| Centrus Health Direct - All Plans | $136 - $191 | 740% |
| Multiplan - All Plans | $142 - $199 | 772% |
| Wppa Providrs Care - All Plans | $164 - $230 | 892% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Amberwell Atchison Association in Atchison, KS, the cash price is $219.00, which matches the facility's median negotiated rate of $100.00 and the cash median. This cash price is significantly higher than the Medicare benchmark of $18.39, reflecting a markup common in commercial billing where negotiated rates often exceed 200% of the federal baseline. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that insurance negotiated rates for this service range from $54 to $230 across 13 different payers. In many cases, paying cash directly can be more cost-effective than using insurance, especially for patients with high deductibles, as the insurance allowed amount may still exceed the cash price due to administrative overhead and contract dynamics.
Consumers should proactively request a self-pay or prompt-pay discount before scheduling, as these upfront fee reductions can lower the final bill by 20% to 50% by bypassing costly claims processing. It is critical to avoid accepting summary bills that obscure individual charges; instead, patients should demand a full itemized CPT-coded statement to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. If a patient receives a balance bill for an out-of-network service at this in-network facility, they should not pay immediately out of fear of credit damage but should instead dispute the charge with their insurer and request a No Surprises Act audit to ensure compliance with federal protections against surprise billing.