CMS Price Transparency Data

Psychological testing evaluation

Facility: Loyola University Medical Center

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $141
Cash Discount Price: $46
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Loyola University Medical Center is $141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 1.04x the Medicare baseline. Located in 2160 S 1St Avenue, Maywood, IL.

Cash / Self-Pay

$46

Average discount available for prompt cash payment at this facility.

Insurance Median

$141

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: $46 (34%)

Insurance Median: $141 (104%)

Cash: $46 (34% of Medicare)

Ins. Median: $141 (104% 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.

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
Cigna	$69 - $138	51%
Blue Cross Blue Shield	$87 - $210	64%
Humana	$94 - $137	69%
Aetna	$129 - $875	95%
Molina	$141 - $875	104%
Wellcare	$141	104%
Oscar Ifp	$148	109%
Meridian	$153 - $875	113%
Molina Marketplace Ifp	$198	146%
UnitedHealthcare	$267 - $291	196%

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 $46.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96136.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Loyola University Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96136.
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.