Blood test, PSA (prostate screen)
Facility: Susan B Allen Memorial Hospital
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $554
- Cash Discount Price: $128
- vs. Medicare Baseline: 30.13x 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 3013% of the Medicare baseline (a markup of 2913%). 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 | $350 | 1903% |
| Providrs Care | $757 | 4116% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Susan B Allen Memorial Hospital in El Dorado, KS, the cash median price is $128.00, which is significantly lower than the facility's negotiated rates of $554.00 and the specific payer rates of $350.00 and $757.00. This price difference highlights a common billing dynamic where commercial insurance negotiated rates often exceed cash prices due to administrative costs and contract structures. Patients with high-deductible plans or those without insurance may find the cash price of $128.00 to be the most cost-effective option, provided they qualify for the facility's self-pay or prompt-pay discounts. It is important to verify these discounts directly with the hospital before scheduling to ensure the lowest possible out-of-pocket cost.
When evaluating the cost of this service, it is essential to compare rates against the Medicare benchmark rather than the hospital's full chargemaster list. The Medicare amount for this code is $18.39, and the data indicates a 30.1% variance between the cash price and the Medicare rate. While the facility is a voluntary non-profit acute care hospital, the specific comparison data provided does not include state or county average figures for this procedure. Consumers should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but patients should still request an itemized bill to ensure no unbundled charges or services not rendered are included in the final invoice.