CMS Price Transparency Data

Psychological testing evaluation

Facility: Adventist Health Lodi Memorial

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $42
  • Cash Discount Price: $6
  • vs. Medicare Baseline: 0.31x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Adventist Health Lodi Memorial is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.31x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$6

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.93

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.93 (100%)
Cash / Self-Pay: $6 (4%)
Insurance Median: $42 (31%)
Cash: $6 (4% of Medicare)
Ins. Median: $42 (31% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $135.93 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.

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
Medcore(Omni Ipa) Op Only- All Plans $15 11%
Blue Shield Epn - All Other Plans $18 - $71 13%
Blue Shield Non-Epn $19 - $75 14%
Alignment Health Plan (Ahp)-All Plans $22 - $175 16%
Blue Shield Mcare Adv $22 - $175 16%
Healthnet Mcare $22 - $175 16%
Hp Of San Joaquin Mcr Adv $22 - $175 16%
Humana $22 - $175 16%
Knnex Health - All Plans $22 - $211 16%
Tricare $22 - $175 16%
UnitedHealthcare $22 - $612 16%
Aetna $23 - $30 17%
Hp Healthy Kids Pro Fee $23 17%
Kaiser Commercial - All Other Plans $23 - $29 17%
Ah Employee Health Plan - All Plans $24 - $316 18%
First Health- All Plans $26 - $47 19%
Beech Street- All Plans $28 - $51 21%
Cigna $28 - $51 21%
Healthnet- All Other Plans $28 - $31 21%
Hp Of San Joaquin Ppo - All Other Plans $28 - $54 21%
Multiplan- All Plans $28 - $46 21%
Networks By Design- All Plans $28 - $29 21%
Kaiser Mcr Adv $29 - $175 21%
Western Growers- All Plans $31 - $51 23%
Blue Cross Blue Shield $37 - $205 27%
Bc Mcal $42 - $58 31%
Celtic Ins Company - All Plans $42 - $57 31%
Kaiser Mcal $42 - $57 31%
Medi-Cal $42 - $57 31%
Hp Mcal Pro Fee $46 34%
Healthnet Mcal $50 - $57 37%
Hp Of San Joaquin Mcal $50 - $57 37%
Three Rivers Provider Network- All Plans $51 38%
Cca Health Plan Mcr Adv- All Plans $175 129%
Bright Health - All Plans $351 258%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals