CMS Price Transparency Data

Psychological testing evaluation

Facility: Baptist Health Medical Center - Jacksonville

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $311
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.29x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Baptist Health Medical Center - Jacksonville is $311. 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 2.29x the Medicare baseline. Located in 800 Prudential Dr, Jacksonville, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$311

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: $311 (229%)

Ins. Median: $311 (229% 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 229% of the Medicare baseline (a markup of 129%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Corvel	$27	20%
Coventry Workers Comp	$27	20%
Community Hospice Of Northeast Florida	$129	95%
Pace	$129	95%
Tomorrow'S Rainbow	$129	95%
Va Ccn	$129	95%
UnitedHealthcare	$130 - $131	96%
Aetna	$131 - $473	96%
Florida Community Care	$135 - $434	99%
Devoted	$137	101%
Upmc	$142	104%
Ambetter / Centene	$309 - $311	227%
Amerigroup Of Georgia	$394	290%
Caresource Of Georgia	$394	290%
Daniel Memorial	$394	290%
Humana	$394 - $434	290%
Peach State Health Plan	$394	290%
Simply Healthcare Plans	$414 - $473	305%
Simply Healthcare Plans - Cha	$414	305%
Amerihealth Caritas	$434	319%
Sunshine State Health Plan	$434	319%
United Community Plan	$434	319%
Vivida Health	$434	319%
Molina Healthcare Of Florida	$469	345%

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 Baptist Health Medical Center - Jacksonville 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.