CMS Price Transparency Data

Psychological testing by technician

Facility: Carle Eureka Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $121
Cash Discount Price: $690
vs. Medicare Baseline: 0.27x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Carle Eureka Hospital is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $690. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.27x the Medicare baseline. Located in 101 S Major St, Eureka, IL.

Cash / Self-Pay

$690

Average discount available for prompt cash payment at this facility.

Insurance Median

$121

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: $690 (151%)

Insurance Median: $121 (27%)

Cash: $690 (151% of Medicare)

Ins. Median: $121 (27% 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.

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
Meridian	$18 - $575	4%
Humana	$31 - $539	7%
Aetna	$32 - $791	7%
Molina	$36 - $575	8%
UnitedHealthcare	$82 - $739	18%
Community Partners Health Plan (Cphp)	$109 - $718	24%
Cigna	$113 - $742	25%
Healthlink	$118 - $778	26%
Blue Cross Blue Shield	$122 - $1,005	27%
Multiplan/Phcs	$136 - $898	30%
Wellcare	$479	105%

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 $690.
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 Carle Eureka 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.