CMS Price Transparency Data

Psychological testing by technician

Facility: Valley Children's Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96138
  • Insurance Median: $186
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.41x Medicare
The contracted insurance negotiated median rate for a Psychological testing by technician at Valley Children's Hospital is $186. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.41x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$186

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%)
Insurance Median: $186 (41%)
Ins. Median: $186 (41% 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.

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
Allcare Ipa $36 8%
Community Care Ipa $36 - $56 8%
Dignity Ipa_Formerly Img $50 11%
La Salle Ipa $50 11%
Sante Ipa $50 11%
Kaiser $52 - $218 11%
Central Valley Medical Providers Ipa $54 - $168 12%
Sequoia Health Ipa $54 12%
Univseral Healthcare Ipa $54 12%
United Physicians Network Ipa $55 12%
Adventist $63 14%
Blue Cross Blue Shield $65 - $191 14%
Cencal Health $71 16%
Kern Family Health Care $71 16%
Central California Alliance For Health $73 16%
Health Net $118 - $220 26%
Dignity Health Central Coast $166 36%
Community Health $185 41%
Stanislaus Partners In Health $185 41%
Physicians Choice Medical Group $188 41%
Health Plan Of San Joaquin $202 44%
Fowler Packing $208 46%
Dignity (Formerly Managed Care Systems) $212 46%
Kern Legacy $218 48%
Blue Shield $224 - $255 49%
Aetna $225 49%
UnitedHealthcare $225 - $239 49%
First Health Formerly Coventry $249 55%
Bakersfield Family Medical Group $252 55%
Network By Design $260 57%
Community Care Health Plan $269 59%
Health Smart $269 59%
Key Medical Ipa $269 59%
Sutter Health $286 63%
Multiplan $321 70%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens