CMS Price Transparency Data

Psychological testing by technician

Facility: Anderson Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96138
  • Insurance Median: $4,814
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 10.55x Medicare
The contracted insurance negotiated median rate for a Psychological testing by technician at Anderson Hospital is $4,814. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 10.55x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,814

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%)
Insurance Median: $4,814 (1055%)
Ins. Median: $4,814 (1055% 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 1055% of the Medicare baseline (a markup of 955%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Tricare $31 - $5,728 7%
Humana $35 - $4,814 8%
Medicare (plans) $35 - $4,814 8%
UnitedHealthcare $35 - $4,814 8%
Medicaid / KanCare $733 161%
Aetna $4,814 1055%
Devoted Health Ppo $4,910 1076%
Essence $4,910 - $5,057 1076%
Clear Springs Health $4,958 1086%
Ambetter / Centene $7,119 1560%
Blue Choice $7,119 1560%
Hopetrust $12,275 2690%
Self Pay $25,000 5478%
Work Comp $26,600 5828%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6800 State Route 162, Maryville, IL 62062
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals