CMS Price Transparency Data

Psychological testing by technician

Facility: Mt Sinai Hospital Medical Center

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96138
  • Insurance Median: $479
  • Cash Discount Price: $370
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Psychological testing by technician at Mt Sinai Hospital Medical Center is $479. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $370. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 1.05x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$370

Average discount available for prompt cash payment at this facility.

Insurance Median
$479

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: $370 (81%)
Insurance Median: $479 (105%)
Cash: $370 (81% of Medicare)
Ins. Median: $479 (105% 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.

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
Partners In Hlth - All Plans $51 - $372 11%
Blue Cross Blue Shield $57 - $911 12%
Compsych Ip/Op Only - All Plans $76 - $557 17%
Healthlink Hmo $83 - $604 18%
Hfn Platinum $83 - $604 18%
Healthlink Ppo - All Other Plans $89 - $650 20%
Multiplan Primary Ntwrk/Phcs - All Other Plans $89 - $650 20%
Hfn Epo $102 - $743 22%
Multiplan Complementary Ntwrk $102 - $743 22%
Hfn Ppo - All Other Plans $112 - $817 25%
Ambetter / Centene $133 - $975 29%
Oscar - All Plans $140 - $1,022 31%
Cigna $157 - $1,148 34%
UnitedHealthcare $196 - $479 43%
Aetna $287 - $2,099 63%
Humana $399 - $2,917 87%
Tricare $464 102%
Va Healthnet - All Plans $464 102%
Advocate Physician Prtnrs Mcr $479 105%
Cenpatico Illinicare Dual $479 105%
Cenpatico Illinicare Mcr - All Other Plans $479 105%
Lawndale Christian - All Plans $479 105%
Meridian/Harmony D-Snp - All Plans $479 105%
Nextlevel Hlth Icp Fhp Aca - All Plans $479 105%
Harmony Behavioral Htlh - All Plans $493 108%
Zing Mcr Adv - All Plans $498 109%
Molina Mcr - All Other Plans $503 110%
Advocate Physician Prtnrs - All Other Plans $527 115%
Family Health Network Mcaid - All Plans $911 200%
Molina Mcaid $957 210%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals