CMS Price Transparency Data

Psychological testing evaluation

Facility: St Alexius Medical Center

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $138
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at St Alexius Medical Center is $138. 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 1.02x the Medicare baseline. Located in 1555 N Barrington Rd, Hoffman Estates, IL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$138

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: $138 (102%)
Ins. Median: $138 (102% 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.

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 $12 - $140 9%
Aarp $128 94%
UnitedHealthcare $128 - $136 94%
Aetna $134 - $148 99%
Blue Cross Blue Shield $134 - $238 99%
Covid-19 Uninsured $134 99%
Humana $134 99%
Medicare (plans) $134 - $138 99%
Molina Healthcare Of Illinois $138 102%
County Care $148 109%
Harmony Health Plan $148 109%
Illinicare $148 109%
Medicaid / KanCare $148 109%
Meridian $148 109%
Bright Health $168 124%
Smarthealth $188 138%
Actin Care $208 153%
Ambetter / Centene $218 160%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1555 N Barrington Rd, Hoffman Estates, IL 60169
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals