CMS Price Transparency Data

Psychological testing by technician

Facility: Northwestern Medicine Kishwaukee Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $986
Cash Discount Price: $921
vs. Medicare Baseline: 2.16x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Northwestern Medicine Kishwaukee Hospital is $986. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $921. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 2.16x the Medicare baseline. Located in One Kish Hospital Drive, Dekalb, IL.

Cash / Self-Pay

$921

Average discount available for prompt cash payment at this facility.

Insurance Median

$986

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: $921 (202%)

Insurance Median: $986 (216%)

Cash: $921 (202% of Medicare)

Ins. Median: $986 (216% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 216% of the Medicare baseline (a markup of 116%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$241 - $1,131	53%
Health'S Finest Network [126]	$592 - $1,210	130%
UnitedHealthcare	$660 - $1,315	145%
Cigna	$693 - $698	152%
Blue Cross Blue Shield	$735 - $1,315	161%
The Alliance [1703]	$855	187%
Healthlink [125]	$986	216%
Choicecare [177]	$994	218%
Multiplan/Phcs [142]	$1,026 - $1,315	225%
Coventry [1218]	$1,131	248%
Coventryone Ppo [17110]	$1,131	248%
First Health Plan [6034]	$1,131	248%

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 $921.
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 Northwestern Medicine Kishwaukee 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.