CMS Price Transparency Data

Psychological testing evaluation

Facility: Elkhart General Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $56
Cash Discount Price: $36
vs. Medicare Baseline: 0.41x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Elkhart General Hospital is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.41x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.

Cash / Self-Pay

$36

Average discount available for prompt cash payment at this facility.

Insurance Median

$56

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: $36 (26%)

Insurance Median: $56 (41%)

Cash: $36 (26% of Medicare)

Ins. Median: $56 (41% 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
Devoted Healthcare	$11 - $142	8%
Blue Cross Blue Shield	$12 - $403	9%
Aetna	$25 - $135	18%
Cha	$34 - $44	25%
Immergrun	$34 - $45	25%
Mhs	$36 - $243	26%
Php	$36 - $39	26%
Humana	$38 - $135	28%
UnitedHealthcare	$38 - $135	28%
Cigna	$40 - $43	29%
Multiplan	$40	29%
Encore	$41	30%
Signature	$41	30%
Plain Church	$45 - $203	33%
Heartland	$56	41%
Caresource	$67 - $216	49%
Mdwise	$67 - $73	49%
Mclaren (Mi	$72	53%
Pace	$135	99%

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 $36.
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 Elkhart General 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.