CMS Price Transparency Data

Psychological testing evaluation

Facility: Medstar Health Physical Therapy

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $531
  • Cash Discount Price: $531
  • vs. Medicare Baseline: 3.91x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation 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 $135.93, this hospital’s rate is 3.91x 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
$135.93

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.93 (100%)
Cash / Self-Pay: $531 (391%)
Insurance Median: $531 (391%)
Cash: $531 (391% of Medicare)
Ins. Median: $531 (391% 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 391% of the Medicare baseline (a markup of 291%). 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 Advantage Inc $139 102%
Tricare $142 104%
UnitedHealthcare $142 - $556 104%
Aetna $144 - $572 106%
Health Care Service Corporation $146 107%
Humana $146 107%
Kaiser Permanente $146 - $1,163 107%
Carefirst Blue Choice Inc $400 - $523 294%
Jhhc $531 391%
Pfc $531 391%
Medstar Family Choice Inc $580 427%
Kaiser $639 470%
Cigna $695 511%
First Health $695 511%
Private Healthcare Systems (Phcs) $695 511%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 102 Irving St Nw, Washington, DC 20010
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL