CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: The Children's Mercy Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $91
Cash Discount Price: $78
vs. Medicare Baseline: 4.95x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at The Children's Mercy Hospital is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 4.95x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.

Cash / Self-Pay

$78

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$18.39

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $18.39 (100%)

Cash / Self-Pay: $78 (424%)

Insurance Median: $91 (495%)

Cash: $78 (424% of Medicare)

Ins. Median: $91 (495% of 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.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

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	$19 - $149	103%
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%
Centivo	$67 - $144	364%
Health Midwest Comprehensive Care	$67 - $144	364%
Nebraska Furniture Mart	$67 - $144	364%
Orscheln	$67 - $144	364%
Quiktrip	$67 - $144	364%
Wellfit/Centrus	$67 - $144	364%
Wppa Providrs Care	$67 - $144	364%
Humana	$68 - $147	370%
Coventry Health Care Of Kansas	$76 - $164	413%
Coxhealth Network	$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%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $78.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84153.

Insurance In-Network Protection Plan

Contact your insurance company to confirm The Children's Mercy Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84153.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.