CMS Price Transparency Data

Psychological testing evaluation

Facility: Deaconess Illinois Crossroads

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $72
Cash Discount Price: $68
vs. Medicare Baseline: 0.53x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Deaconess Illinois Crossroads is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.53x the Medicare baseline. Located in 8 Doctors Park Rd, Mount Vernon, IL.

Cash / Self-Pay

$68

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

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: $68 (50%)

Insurance Median: $72 (53%)

Cash: $68 (50% of Medicare)

Ins. Median: $72 (53% 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
Aetna	$22 - $153	16%
Blue Cross Blue Shield	$22 - $134	16%
Humana	$22 - $151	16%
Meridian Health Plan	$22 - $134	16%
Molina Healthcare Of Illinois	$22 - $136	16%
Mytru Advantage	$22 - $134	16%
Umwa	$22 - $134	16%
UnitedHealthcare	$22 - $134	16%
Wellcare	$22 - $134	16%
Alliance Coal	$31 - $222	23%
Healthlink	$31 - $34	23%
Deaconess Onecare	$33	24%
Alter-Net Medical Services, Inc.	$35 - $383	26%
Noncontracted	$35 - $215	26%
Self-Pay	$68	50%
Cigna	$75	55%
Care Improvement Plus	$137	101%
Prime Health Services	$146	107%
Guardian Resources, Inc.	$163	120%
Healthcare'S Finest Network (Hfn)	$165	121%
Medicalcontrol Network Solutions	$165	121%
National Provider Network	$165	121%
Three Rivers Provider Network	$169	124%
Beech Street	$171	126%
Hope Trust	$383	282%

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 $68.
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 Deaconess Illinois Crossroads 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.