CMS Price Transparency Data

Psychological testing by technician

Facility: Cleveland Clinic Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $365
Cash Discount Price: $571
vs. Medicare Baseline: 0.80x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Cleveland Clinic Hospital is $365. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $571. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.80x the Medicare baseline. Located in 3100 Weston Rd, Weston, FL.

Cash / Self-Pay

$571

Average discount available for prompt cash payment at this facility.

Insurance Median

$365

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$456.4

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $456.4 (100%)

Cash / Self-Pay: $571 (125%)

Insurance Median: $365 (80%)

Cash: $571 (125% of Medicare)

Ins. Median: $365 (80% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $456.4 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	$34 - $865	7%
Blue Cross Blue Shield	$34 - $401	7%
Doctors Health Plan	$34 - $401	7%
United	$34 - $1,881	7%
Wellcare	$34 - $401	7%
Independent Living Systems	$36 - $421	8%
Clear Spring Health	$37 - $52	8%
Cigna	$39 - $287	9%
Aetna	$42 - $679	9%
Maritime	$365 - $514	80%
Multiplan	$365 - $873	80%
Humana	$401	88%
Devoted Health	$441	97%
Clarity Health	$474 - $668	104%
The Legacy Companies	$474 - $668	104%
Consociate Health	$548	120%
Bmi	$565	124%

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 $571.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96138.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Cleveland Clinic Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96138.
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.