Psychological testing by technician
Facility: Pratt Regional Medical Center
Billing Code: 96138 (CPT)
- CPT Billing Code: 96138
- Insurance Median: $93
- Cash Discount Price: $65
- vs. Medicare Baseline: 0.20x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Christian Health Aid | $70 | 15% |
| UnitedHealthcare | $77 - $406 | 17% |
| Health Partners Of Kansas | $79 | 17% |
| Aetna | $84 | 18% |
| Choicecare | $93 | 20% |
| Celtic Insurance Company | $369 | 81% |
| Healthy Blue | $380 | 83% |
Consumer Guidance & Cost Commentary
For the CPT code 96138, "Psychological testing by technician," Pratt Regional Medical Center in Pratt, KS, lists a cash median price of $65.00, which is lower than the facility's gross charge of $93.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Celtic Insurance Company range from $77 to $380, patients with high-deductible plans may find the cash price more advantageous if the insurance negotiated rate exceeds this amount. It is important to note that cash-pay rates can sometimes be cheaper for patients who do not have active insurance coverage or are paying out-of-pocket, as the facility offers a self-pay classification that bypasses the administrative costs associated with insurance billing cycles.
When evaluating the cost of this service, it is critical to compare rates against the Medicare benchmark rather than the hospital's gross chargemaster. The Medicare amount for this procedure is $456.40, and the facility's negotiated rate of $93.00 represents a significant portion of this federal baseline, aligning with fair pricing standards that typically range between 120% and 150% of the Medicare rate. To ensure you are receiving the best possible price, patients should request an itemized bill to verify that no unbundled codes or services not rendered have been charged, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute. Additionally, asking about prompt-pay discounts before scheduling the service can help secure immediate liquidity benefits, potentially reducing the final amount owed by 20% to 50%.