CMS Price Transparency Data

Psychological testing evaluation

Facility: UF Health Shands Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $153
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at UF Health Shands Hospital is $153. 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 1.13x the Medicare baseline. Located in 1600 Sw Archer Rd, Gainesville, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$153

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: $153 (113%)

Ins. Median: $153 (113% 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
Blue Cross Blue Shield	$129 - $139	95%
UnitedHealthcare	$129 - $434	95%
Vha	$129	95%
Capital Health Plan	$139	102%
Humana	$139 - $434	102%
North Central Hospice	$139	102%
Wellcare	$139	102%
Positive Healthcare Partners	$142	104%
Careplus	$143	105%
Carelon Health	$147	108%
Ahf Mco Of Fl	$153	113%
Devoted Health Plan	$153	113%
Freedom Health- Inc./Optimum Healthcare- Inc.	$153	113%
Ghilcrest County	$162	119%
Levy County	$162	119%
Wellpath	$207	152%
Ambetter / Centene	$215	158%
Florida Health Care Plan	$233	171%
Beacon Health Strategies	$434	319%
Sunshine State Health Plan	$434	319%
Aetna	$453 - $454	333%
Florida Community Care	$454	334%
Simply Healthcare	$470	346%
Amerihealth Caritas Florida	$473	348%
Community Care Plan	$473	348%
Molina	$473	348%

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 UF Health Shands 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.