CMS Price Transparency Data

Psychological testing by technician

Facility: Alton Memorial Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $192
Cash Discount Price: $187
vs. Medicare Baseline: 0.42x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Alton Memorial Hospital is $192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.42x the Medicare baseline. Located in One Memorial Drive, Alton, IL.

Cash / Self-Pay

$187

Average discount available for prompt cash payment at this facility.

Insurance Median

$192

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: $187 (41%)

Insurance Median: $192 (42%)

Cash: $187 (41% of Medicare)

Ins. Median: $192 (42% 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
Blue Cross Blue Shield	$142 - $271	31%
Cigna	$164	36%
Consociate [478]	$168	37%
Sarah Bush Lincoln [636]	$168	37%
Cox Health Systems Insurance Company [220]	$172	38%
Humana	$173	38%
Allied Benefits [498]	$181 - $251	40%
Hope Trust [806]	$181	40%
Healthscope Benefits [258]	$192	42%
UnitedHealthcare	$192	42%
Healthcare Sol Mercy [609]	$234	51%
Med-Pay [480]	$234	51%
Medica [661]	$250	55%
Phcs [244]	$250	55%
Aetna	$251	55%
Coresource [497]	$251	55%
Fmh Benefit Service Inc [222]	$251	55%
Mail Handlers [495]	$251	55%

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 $187.
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 Alton Memorial 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.