Blood test, PSA (prostate screen)
Facility: Bob Wilson Memorial Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $151
- Cash Discount Price: $74
- vs. Medicare Baseline: 8.21x 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 821% of the Medicare baseline (a markup of 721%). 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 |
|---|---|---|
| Centura Employee Plan | $23 | 125% |
| Humana | $59 | 321% |
| Aetna | $59 - $147 | 321% |
| UnitedHealthcare | $59 - $154 | 321% |
| Medicare (plans) | $59 | 321% |
| Kansas Health | $59 | 321% |
| Blue Cross Blue Shield | $91 | 495% |
| Multiplan | $166 - $171 | 903% |
| Health Partners Of Kansas | $173 | 941% |
| Wppa | $175 | 952% |
Consumer Guidance & Cost Commentary
For the prostate screening service (CPT 84153) at Bob Wilson Memorial Hospital in Ulysses, KS, the facility's cash price of $74.00 is significantly lower than the median negotiated rate of $151.00 and the gross charge of $184.00. While Medicare sets a baseline payment of $18.39 for this procedure, commercial payers negotiate rates that range widely, with the lowest allowed amount being $23 and the highest reaching $175. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as it avoids the administrative overhead and higher negotiated rates often associated with insurance claims. It is important to note that while the facility is a Critical Access Hospital owned by a voluntary non-profit church, the specific negotiated rates vary by payer, with some plans like Multiplan paying up to $171 and others like Centura Employee Plan paying only $23.
Before scheduling, patients should verify their specific plan's allowed amount, as in-network status does not guarantee the lowest possible price; some commercial contracts may exceed the cash-pay option. If you choose to use insurance, be aware that you may be responsible for the difference between the negotiated rate and your deductible, which could result in unexpected out-of-pocket costs. To minimize expenses, contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront. Additionally, if you receive an itemized bill, request a full line-by-line audit to ensure no errors or unbundled charges are included, as over 8