CMS Price Transparency Data

Psychological testing evaluation

Facility: Winter Haven Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $45
Cash Discount Price: $34
vs. Medicare Baseline: 0.33x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Winter Haven Hospital is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.33x the Medicare baseline. Located in 200 Ave F Ne, Winter Haven, FL.

Cash / Self-Pay

$34

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $34 (25%)

Insurance Median: $45 (33%)

Cash: $34 (25% of Medicare)

Ins. Median: $45 (33% 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
Molina	$10 - $33	7%
Simply Healthcare	$10	7%
Avmed	$17 - $27	13%
Ultimate Health Plan	$17	13%
Blue Cross Blue Shield	$18 - $129	13%
Aetna	$26 - $149	19%
Florida Hospital	$26	19%
Evolutions	$28 - $52	21%
Cigna	$30 - $149	22%
UnitedHealthcare	$30 - $138	22%
Multiplan	$45	33%
First Health	$48	35%
Ambetter / Centene	$56 - $330	41%
United Behavioral Health	$56	41%
Baycareplus	$129	95%
Careplus	$131	96%
Humana	$134 - $162	99%
Freedom	$141	104%
Optimum	$141	104%
Solis Health	$142	104%
Health First	$149	110%
Wellcare	$181	133%

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 $34.
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 Winter Haven Hospital 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.