CMS Price Transparency Data

Psychological testing evaluation

Facility: Valley Children's Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $188
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.38x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Valley Children's Hospital is $188. 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 $135.93, this hospital’s rate is 1.38x 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
$188

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%)
Insurance Median: $188 (138%)
Ins. Median: $188 (138% 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
Allcare Ipa $42 31%
Community Care Ipa $42 - $66 31%
Dignity Ipa_Formerly Img $59 43%
La Salle Ipa $59 43%
Sante Ipa $59 43%
Kaiser $61 - $218 45%
Central Valley Medical Providers Ipa $63 - $168 46%
Sequoia Health Ipa $63 46%
Univseral Healthcare Ipa $63 46%
United Physicians Network Ipa $65 48%
Adventist $74 54%
Blue Cross Blue Shield $76 - $191 56%
Cencal Health $83 61%
Kern Family Health Care $84 62%
Health Net $118 - $220 87%
Dignity Health Central Coast $166 122%
Community Health $185 136%
Stanislaus Partners In Health $185 136%
Physicians Choice Medical Group $188 138%
Health Plan Of San Joaquin $202 149%
Fowler Packing $208 153%
Dignity (Formerly Managed Care Systems) $212 156%
Kern Legacy $218 160%
Blue Shield $224 - $255 165%
Aetna $225 166%
UnitedHealthcare $225 - $239 166%
First Health Formerly Coventry $249 183%
Bakersfield Family Medical Group $252 185%
Network By Design $260 191%
Community Care Health Plan $269 198%
Health Smart $269 198%
Key Medical Ipa $269 198%
Sutter Health $286 210%
Multiplan $321 236%

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