CMS Price Transparency Data

Psychological testing evaluation

Facility: Medstar Washington Hospital Center

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $1,005
  • Cash Discount Price: $1,094
  • vs. Medicare Baseline: 7.39x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Medstar Washington Hospital Center is $1,005. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,094. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 7.39x the Medicare baseline. Located in 110 Irving Street Nw, Washington, DC.
Cash / Self-Pay
$1,094

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,005

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: $1,094 (805%)
Insurance Median: $1,005 (739%)
Cash: $1,094 (805% of Medicare)
Ins. Median: $1,005 (739% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 739% of the Medicare baseline (a markup of 639%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Carefirst Blue Choice Inc $116 85%
Carefirst Advantage Inc $157 116%
Tricare $157 116%
UnitedHealthcare $157 - $488 116%
Aetna $162 - $1,078 119%
Health Care Service Corporation $165 121%
Humana $165 121%
Kaiser Permanente $165 - $1,163 121%
Medstar Family Choice Inc $808 - $1,327 594%
Cigna $1,005 739%
Pfc $1,094 805%
Ncppo Healthlink Ppo $1,263 929%
Amerigroup $1,327 976%
Amerihealth Caritas District Of Columbia $1,327 976%
Hscsn $1,327 976%
Private Healthcare Systems (Phcs) $1,347 991%
First Health $1,431 1053%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 110 Irving Street Nw, Washington, DC 20010
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals