CMS Price Transparency Data

Psychological testing by technician

Facility: Winter Haven Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $71
Cash Discount Price: $47
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Winter Haven Hospital is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.16x the Medicare baseline. Located in 200 Ave F Ne, Winter Haven, FL.

Cash / Self-Pay

$47

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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: $47 (10%)

Insurance Median: $71 (16%)

Cash: $47 (10% of Medicare)

Ins. Median: $71 (16% 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
Molina	$14 - $47	3%
Simply Healthcare	$14 - $5,297	3%
Avmed	$24 - $39	5%
Ultimate Health Plan	$24	5%
Blue Cross Blue Shield	$25 - $401	5%
Florida Hospital	$36	8%
Aetna	$37 - $5,398	8%
Evolutions	$40 - $73	9%
Cigna	$42 - $461	9%
UnitedHealthcare	$42 - $5,145	9%
Multiplan	$63	14%
First Health	$67	15%
Ambetter / Centene	$79 - $1,021	17%
United Behavioral Health	$79	17%
Baycareplus	$401	88%
Careplus	$409	90%
Humana	$416 - $5,246	91%
Freedom	$440	96%
Optimum	$440	96%
Solis Health	$441	97%
Health First	$461	101%
Wellcare	$561	123%
Clear Health Alliance	$5,095	1116%
Freedom Health	$5,297	1161%
Molina Healthcare	$5,297	1161%
Sunshine Health	$5,297	1161%
Florida Community Care	$5,549	1216%

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 $47.
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 Winter Haven Hospital 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.