Blood test, PSA (prostate screen)
Facility: Children'S Mercy South
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $91
- Cash Discount Price: $78
- vs. Medicare Baseline: 4.95x 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 495% of the Medicare baseline (a markup of 395%). 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 | $17 - $149 | 92% |
| Healthy Blue | $21 - $50 | 114% |
| Medicaid / KanCare | $22 | 120% |
| Blue Cross Blue Shield | $42 - $164 | 228% |
| Home State Health | $44 | 239% |
| Cigna | $49 - $154 | 266% |
| Medica | $60 - $129 | 326% |
| Aetna | $62 - $150 | 337% |
| Health Midwest Comprehensive Care | $67 - $144 | 364% |
| Centivo | $67 - $144 | 364% |
| Wppa Providrs Care | $67 - $144 | 364% |
| Wellfit/Centrus | $67 - $144 | 364% |
| Nebraska Furniture Mart | $67 - $144 | 364% |
| Quiktrip | $67 - $144 | 364% |
| Orscheln | $67 - $144 | 364% |
| Humana | $68 - $147 | 370% |
| Coxhealth Network | $76 - $164 | 413% |
| Coventry Health Care Of Kansas | $76 - $164 | 413% |
| Mercy Health | $77 - $166 | 419% |
| Multiplan | $78 - $168 | 424% |
| American Healthcare Alliance | $88 - $188 | 479% |
| Healthlink | $91 - $194 | 495% |
| National Preferred Provider Network | $93 - $199 | 506% |
Consumer Guidance & Cost Commentary
For the CPT code 84153, a blood test for prostate screening, Children's Mercy South in Overland Park, KS, lists a gross charge of $162.00. The facility's cash median rate is $78.00, which is significantly lower than the negotiated rates paid by insurance carriers. While the facility's negotiated rate of $91.00 is higher than the cash price, it remains below the highest negotiated rates found in the state, with some commercial payers ranging up to $199.00. For patients with high-deductible plans, paying the cash price of $78.00 upfront may be more cost-effective than relying on insurance, as the insurer's allowed amount could exceed the cash rate. Patients should verify their specific plan's deductible status and ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not charged the full negotiated rate.
This service is priced at 4.9 times the Medicare amount of $18.39, which serves as the federal benchmark for healthcare costs. Although the facility is a voluntary non-profit, the commercial negotiated rates vary widely across 23 different payers, with the lowest being $17.00 and the highest reaching $199.00. It is important to note that commercial rates often include administrative overhead and do not represent the true cost of care, which is better reflected by the Medicare rate. Consumers should avoid accepting summary bills that obscure individual line items and instead request a detailed itemized statement to identify any unbundled codes or services not rendered. Furthermore, under federal protections like the No Surprises Act,