Blood test, PSA (prostate screen)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $19
- Cash Discount Price: $61
- vs. Medicare Baseline: 1.03x 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.
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 |
|---|---|---|
| Smarthealth | $17 - $26 | 92% |
| UnitedHealthcare | $18 - $51 | 98% |
| Medicare (plans) | $18 - $19 | 98% |
| Providrs Care | $18 | 98% |
| Va | $18 | 98% |
| Humana | $18 - $19 | 98% |
| Aetna | $19 | 103% |
| Medicaid / KanCare | $19 | 103% |
| Ambetter / Centene | $31 | 169% |
| Blue Cross Blue Shield | $65 - $167 | 353% |
Consumer Guidance & Cost Commentary
For this blood test, PSA (prostate screen) procedure at Ascension Via Christi Hospital Manhattan, the facility's cash median price is $61.00, which is significantly higher than the state average of $18.39. While commercial insurance plans like Blue Cross Blue Shield negotiate rates as high as $167, patients with high-deductible plans might find the cash price more affordable if their insurance allowed amount exceeds $61.00. It is important to note that cash-pay options can sometimes be cheaper for self-pay patients, but hospitals often offer additional "self-pay" or "prompt-pay" discounts for upfront payments, so contacting the billing department before scheduling is recommended to verify the lowest possible rate.
The facility's negotiated rates vary widely among payers, ranging from $17 for Smarthealth to $167 for Blue Cross Blue Shield, with a median negotiated rate of $19.00 across all plans. This variation highlights that in-network status does not guarantee the lowest price, as different insurers contract at different levels. To avoid unexpected costs, patients should request a full itemized bill to review specific CPT codes and ensure no unbundled charges or services not rendered are included, as over 80% of hospital bills contain errors. Additionally, if a patient receives care from an out-of-network provider at this in-network facility, the No Surprises Act protects them from balance billing for emergency and non-emergency services, making it essential to dispute any surprise bills immediately rather than accepting summary invoices.