CMS Price Transparency Data

Psychological testing evaluation

Facility: Ascension St Vincent's Riverside

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $131
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Ascension St Vincent's Riverside is $131. 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 0.96x the Medicare baseline. Located in 1 Shircliff Way, Jacksonville, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $131 (96%)

Ins. Median: $131 (96% 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.

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
Humana	$100 - $131	74%
Bc Advantage Mcr Replacement	$129	95%
Blue Cross Blue Shield	$129	95%
Community Hospice	$129	95%
Coventry Mcr Replacement Hmo	$129	95%
Haven Hospice	$129	95%
Heartland Of Hc	$129	95%
Medicare (plans)	$129 - $132	95%
Pace Place	$129	95%
Research Study Encore Borland-Groover	$129	95%
Veterans Administration	$129	95%
Wellcare	$129	95%
Cigna	$131 - $132	96%
UnitedHealthcare	$131	96%
Careplus Mcr Replacement	$132	97%
Aetna	$133 - $265	98%
Bright Health	$175 - $188	129%
Smarthealth	$181	133%
Oscar Health Plan	$207	152%
Employer Direct Healthcare	$226	166%
90 Degree Benefits	$233	171%
Avmed Exchange	$233	171%
Molina Exchange	$239	176%
Occunet	$239 - $291	176%
Ambetter / Centene	$246	181%

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: 96136.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ascension St Vincent's Riverside is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96136.
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.