CMS Price Transparency Data

Psychological testing by technician

Facility: Boulder Community Health

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $59
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.13x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Boulder Community Health is $59. 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 0.13x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $59 (13%)

Ins. Median: $59 (13% 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
Colorado Community Health Alliance (Ccha)	$31	7%
Medicaid / KanCare	$33	7%
Rocky Mountain Health Maintenance Organization	$33 - $413	7%
Aetna	$35 - $401	8%
Blue Cross Blue Shield	$35 - $1,515	8%
Devoted Health	$35 - $401	8%
Health Spring	$35 - $401	8%
Humana	$35 - $401	8%
Medicare (plans)	$35 - $413	8%
UnitedHealthcare	$35 - $412	8%
Clear Spring	$36 - $413	8%
Colorado Access	$36 - $43	8%
Select Health Colorado Public Option	$49 - $882	11%
Select Health Value Network	$49 - $934	11%
Kaiser Ppo	$54 - $944	12%
Kaiser Public Option	$54 - $769	12%
Beech Street Community Medical Associates	$55	12%
Multiplan	$56	12%
Phcs	$56	12%
Cigna	$58	13%
Kaiser	$940	206%

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 $X.
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 Boulder Community Health 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.