CMS Price Transparency Data

Psychological testing evaluation

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $34
Cash Discount Price: $154
vs. Medicare Baseline: 0.25x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Cleveland Clinic Indian River Hospital is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $154. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.25x the Medicare baseline. Located in 1000 36Th St, Vero Beach, FL.

Cash / Self-Pay

$154

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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: $154 (113%)

Insurance Median: $34 (25%)

Cash: $154 (113% of Medicare)

Ins. Median: $34 (25% 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
Avmed	$23 - $296	17%
Blue Cross Blue Shield	$23 - $129	17%
Careplus	$23 - $129	17%
Magellan	$23 - $38	17%
United	$23 - $129	17%
Value Options	$23 - $32	17%
Wellcare	$23 - $129	17%
Cigna	$25 - $33	18%
Clear Spring Health	$25	18%
Freedom Health	$25 - $129	18%
Independent Living Systems	$25 - $136	18%
Wellmed	$25 - $129	18%
Aetna	$28 - $213	21%
UnitedHealthcare	$31	23%
Amerihealth	$32	24%
Medicaid / KanCare	$32	24%
Molina	$32	24%
Carelon Bh Strategies	$129	95%
Humana	$129	95%
Devoted Health	$142	104%
Clarity Health	$154	113%
The Legacy Companies	$154	113%
National Provider Network	$166	122%
Three Rivers	$166	122%
Consociate Health	$178	131%

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 $154.
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 Cleveland Clinic Indian River 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.