CMS Price Transparency Data

Psychological testing evaluation

Facility: Carle Eureka Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $150
Cash Discount Price: $349
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Carle Eureka Hospital is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $349. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 1.10x the Medicare baseline. Located in 101 S Major St, Eureka, IL.

Cash / Self-Pay

$349

Average discount available for prompt cash payment at this facility.

Insurance Median

$150

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: $349 (257%)

Insurance Median: $150 (110%)

Cash: $349 (257% of Medicare)

Ins. Median: $150 (110% 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
Humana	$23 - $207	17%
Aetna	$24 - $304	18%
Meridian	$24 - $221	18%
Molina	$47 - $221	35%
UnitedHealthcare	$107 - $284	79%
Community Partners Health Plan (Cphp)	$142 - $276	104%
Wellcare	$143	105%
Cigna	$147 - $285	108%
Healthlink	$154 - $299	113%
Blue Cross Blue Shield	$159 - $386	117%
Multiplan/Phcs	$178 - $345	131%

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 $349.
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 Carle Eureka Hospital 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.