CMS Price Transparency Data

Psychological testing evaluation

Facility: Mt Sinai Hospital Medical Center

Billing Code: 96136 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$125

about 0.9× the $136 Medicare rate · typically $74–$146

modeled estimate · not a bill or quote

What this hospital charges insurers

$157

Above the fair price

about $32 over the fair price · 1.2× Medicare

Medicare pays $136 Fair price $125 This hospital $157 Cash price $155 Hospital's list price $221

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

Highest price of the 9 IL hospitals we have prices for — worth calling around.

Cheapest $22 Priciest $157

Black dot = this hospital, among the 9 IL hospitals with a price for this procedure. Full list below.

A fair price for a Psychological testing evaluation is about $125 (about 0.9× the $136 Medicare rate). Mt Sinai Hospital Medical Center charges insurers about $157, or about $155 in cash — above the fair price. Located in Chicago, IL.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $125. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$143 - $196	105%
Blue Cross Blue Shieldmajor	$70 - $911	51%
Aetnamajor	$354 - $911	260%
Cignamajor	$134 - $957	99%
Humanamajor	$143 - $897	105%
Ambetter (Centene)	$157 - $300	116%
Health Net	$138 - $911	102%
HealthLink	$102 - $186	75%
Meridian	$143	105%
Molina	$150 - $957	110%
Oscar Health	$173 - $314	127%
+ 10 smaller / regional plans	$63 - $171

Government programs also on file: Military & VA.

Excludes 6 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 155), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 96136.

Insurance Before you use insurance

Call your insurance company to confirm Mt Sinai Hospital Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 96136.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Mt Sinai Hospital Medical Center

Compare: Psychological testing evaluation at other IL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.