CMS Price Transparency Data

Psychological testing evaluation

Facility: Anderson Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $4,771
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 35.10x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Anderson Hospital is $4,771. 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 $135.93, this hospital’s rate is 35.10x 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
$4,771

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%)
Insurance Median: $4,771 (3510%)
Ins. Median: $4,771 (3510% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 3510% of the Medicare baseline (a markup of 3410%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

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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 $39 - $5,692 29%
Humana $42 - $4,771 31%
Medicare (plans) $42 - $4,771 31%
UnitedHealthcare $42 - $4,771 31%
Medicaid / KanCare $733 539%
Aetna $4,771 3510%
Devoted Health Ppo $4,866 3580%
Essence $4,868 - $5,014 3581%
Clear Springs Health $4,914 3615%
Ambetter / Centene $7,058 5192%
Blue Choice $7,058 5192%
Hopetrust $12,170 8953%
Self Pay $25,000 18392%
Work Comp $26,600 19569%

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