CMS Price Transparency Data

Psychological testing by technician

Facility: Medstar Health Physical Therapy

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $531
Cash Discount Price: $531
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Medstar Health Physical Therapy is $531. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $531. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 1.16x the Medicare baseline. Located in 102 Irving St Nw, Washington, DC.

Cash / Self-Pay

$531

Average discount available for prompt cash payment at this facility.

Insurance Median

$531

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%)

Cash / Self-Pay: $531 (116%)

Insurance Median: $531 (116%)

Cash: $531 (116% of Medicare)

Ins. Median: $531 (116% 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
Carefirst Blue Choice Inc	$400 - $523	88%
Carefirst Advantage Inc	$429	94%
Tricare	$436	96%
UnitedHealthcare	$436 - $556	96%
Aetna	$442 - $572	97%
Health Care Service Corporation	$451	99%
Humana	$451	99%
Kaiser Permanente	$451 - $1,163	99%
Jhhc	$531	116%
Pfc	$531	116%
Medstar Family Choice Inc	$580	127%
Kaiser	$639	140%
Cigna	$695	152%
First Health	$695	152%
Private Healthcare Systems (Phcs)	$695	152%

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 $531.
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 Medstar Health Physical Therapy 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.