CMS Price Transparency Data

Psychological testing evaluation

Facility: Lakeside Medical Center

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $129
Cash Discount Price: $129
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Lakeside Medical Center is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.95x the Medicare baseline. Located in 39200 Hooker Hwy, Belle Glade, FL.

Cash / Self-Pay

$129

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $129 (95%)

Insurance Median: $129 (95%)

Cash: $129 (95% of Medicare)

Ins. Median: $129 (95% 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
Aetna	$20 - $129	15%
Geo	$123	90%
Blue Cross Blue Shield	$129	95%
Care Plus	$129	95%
Cigna	$129	95%
Humana	$129	95%
Molina	$129 - $136	95%
Simply Healthcare	$129	95%
UnitedHealthcare	$129	95%
Wellpath	$129	95%
Ambetter / Centene	$136	100%
Sunshine	$136	100%
Wellcare	$136	100%
Devoted	$138	102%
Genesys	$142	104%
Prime Health Plan	$142	104%

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 $129.
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 Lakeside Medical Center 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.