CMS Price Transparency Data

Psychological testing by technician

Facility: Grossmont Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $135
Cash Discount Price: $163
vs. Medicare Baseline: 0.30x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Grossmont Hospital is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.30x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$163

Average discount available for prompt cash payment at this facility.

Insurance Median

$135

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$456.4

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $456.4 (100%)

Cash / Self-Pay: $163 (36%)

Insurance Median: $135 (30%)

Cash: $163 (36% of Medicare)

Ins. Median: $135 (30% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $456.4 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.

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
Cigna	$5 - $195	1%
Aetna	$33 - $174	7%
Health Net	$33 - $152	7%
Epic Americas	$64	14%
San Diego Pace	$64	14%
California Health And Wellness	$74	16%
Medi-Cal	$74	16%
Molina	$108 - $195	24%
Allianz Global Assistance	$120	26%
Community Health Group	$123	27%
UnitedHealthcare	$130 - $167	28%
Blue Shield	$138 - $174	30%
Multiplan	$150	33%
Indian Health Council	$152	33%
Managed Health Network	$152	33%
Blue Cross Blue Shield	$174	38%
Humana	$626	137%

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 $163.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96138.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Grossmont Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96138.
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.