CMS Price Transparency Data

Psychological testing by technician

Facility: Saint Anthony Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $562
Cash Discount Price: $362
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Saint Anthony Hospital is $562. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $362. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 1.23x the Medicare baseline. Located in 2875 West 19Th Street, Chicago, IL.

Cash / Self-Pay

$362

Average discount available for prompt cash payment at this facility.

Insurance Median

$562

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: $362 (79%)

Insurance Median: $562 (123%)

Cash: $362 (79% of Medicare)

Ins. Median: $562 (123% 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
Access Community Health Network	$372 - $416	82%
Aetna	$416 - $904	91%
Blue Cross Blue Shield	$416 - $562	91%
Cigna	$416 - $602	91%
Humana	$416	91%
Oak Street Health	$416	91%
UnitedHealthcare	$416	91%
Zing Health	$416	91%
Healthlink	$688 - $723	151%
Healthsmart	$803 - $844	176%
Galaxy Health Network	$918 - $964	201%
Prime Health	$918 - $964	201%
Zelis Healthcare	$918 - $964	201%

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 $362.
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 Saint Anthony 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.