CMS Price Transparency Data

Psychological testing by technician

Facility: Northwest Health-La Porte

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $88
Cash Discount Price: $43
vs. Medicare Baseline: 0.19x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Northwest Health-La Porte is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.19x the Medicare baseline. Located in 1007 Lincolnway, La Porte, IN.

Cash / Self-Pay

$43

Average discount available for prompt cash payment at this facility.

Insurance Median

$88

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: $43 (9%)

Insurance Median: $88 (19%)

Cash: $43 (9% of Medicare)

Ins. Median: $88 (19% 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
Lutheran	$26	6%
Self Pay	$32 - $53	7%
One Call	$35	8%
Php	$40	9%
Lutheran Preferred Medpartners	$41	9%
Alpha Baking	$44	10%
Php Freedom Network	$59	13%
Encore	$64 - $782	14%
County Of Laporte	$69	15%
UnitedHealthcare	$72 - $434	16%
Cigna	$73	16%
Prime Health Services	$74	16%
Prime Health Services Auto	$74	16%
Aetna	$76 - $427	17%
Ihn	$78	17%
Community Health Alliance	$85	19%
Lutheran Network	$86 - $869	19%
Sagamore Health Network	$86	19%
Chandler Group	$88	19%
Hfn Workers Compensation	$88	19%
Multiplan	$88	19%
Phcs	$88	19%
Blue Cross Blue Shield	$427 - $1,766	94%
Humana	$427	94%
Medicare (plans)	$427	94%
Node Hospice Non Par Agree	$434	95%
Node Va	$434	95%
Va Choice Program	$434	95%
Node Devoted Health Mcr Adv	$436	96%
Managed Health Services	$449 - $869	98%
Indiana Dept Of Correction	$452	99%
Node Pphp Mcr Adv	$456	100%
Us Department Of Labor	$543	119%
Prime Health In Work Comp	$782	171%
In Wc	$869	190%
Encore Kba Epo	$1,042	228%
Magnacare Ma	$1,063	233%
Encore Kba Ppo	$1,303	285%

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 $43.
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 Northwest Health-La Porte 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.