CMS Price Transparency Data

Psychological testing evaluation

Facility: Grady Memorial Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $57
Cash Discount Price: $166
vs. Medicare Baseline: 0.42x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Grady Memorial Hospital is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.42x the Medicare baseline. Located in 80 Jesse Hill, Jr Drive Se, Atlanta, GA.

Cash / Self-Pay

$166

Average discount available for prompt cash payment at this facility.

Insurance Median

$57

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: $166 (122%)

Insurance Median: $57 (42%)

Cash: $166 (122% of Medicare)

Ins. Median: $57 (42% 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
Peach State	$21 - $41	15%
Aetna	$23 - $128	17%
Ambetter / Centene	$23 - $128	17%
Blue Cross Blue Shield	$23 - $133	17%
Cigna	$23 - $172	17%
Humana	$23 - $128	17%
Kaiser	$23 - $128	17%
Medicare (plans)	$23 - $128	17%
UnitedHealthcare	$23 - $128	17%
Vaccn	$23 - $128	17%
Wellcare	$23 - $128	17%
Clear Spring Health	$24 - $135	18%
Clover	$24 - $135	18%
Caresource	$25 - $205	18%
Usp Naphcare	$25 - $237	18%
Amerigroup	$27 - $41	20%
Oscar Health	$32 - $213	24%
Multiplan	$128	94%

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 $166.
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 Grady Memorial 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.