CMS Price Transparency Data

Psychological testing evaluation

Facility: Mt Sinai Hospital Medical Center

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $149
  • Cash Discount Price: $155
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Mt Sinai Hospital Medical Center is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $155. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 1.10x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$155

Average discount available for prompt cash payment at this facility.

Insurance Median
$149

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: $155 (114%)
Insurance Median: $149 (110%)
Cash: $155 (114% of Medicare)
Ins. Median: $149 (110% 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.

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 $63 - $114 46%
Blue Cross Blue Shield $70 - $911 51%
Compsych Ip/Op Only - All Plans $94 - $171 69%
Healthlink Hmo $102 - $186 75%
Hfn Platinum $102 - $186 75%
Healthlink Ppo - All Other Plans $110 - $200 81%
Multiplan Primary Ntwrk/Phcs - All Other Plans $110 - $200 81%
Hfn Epo $125 - $229 92%
Multiplan Complementary Ntwrk $125 - $229 92%
Cigna $134 - $957 99%
Hfn Ppo - All Other Plans $138 - $251 102%
Tricare $138 102%
Va Healthnet - All Plans $138 102%
Advocate Physician Prtnrs Mcr $143 105%
Cenpatico Illinicare Dual $143 105%
Cenpatico Illinicare Mcr - All Other Plans $143 105%
Humana $143 - $897 105%
Lawndale Christian - All Plans $143 105%
Meridian/Harmony D-Snp - All Plans $143 105%
Nextlevel Hlth Icp Fhp Aca - All Plans $143 105%
UnitedHealthcare $143 - $196 105%
Harmony Behavioral Htlh - All Plans $147 108%
Zing Mcr Adv - All Plans $148 109%
Molina Mcr - All Other Plans $150 110%
Advocate Physician Prtnrs - All Other Plans $157 116%
Ambetter / Centene $157 - $300 116%
Oscar - All Plans $173 - $314 127%
Aetna $354 - $911 260%
Family Health Network Mcaid - All Plans $911 670%
Molina Mcaid $957 704%

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