Psychological testing evaluation
Facility: Pratt Regional Medical Center
Billing Code: 96136 (CPT)
- CPT Billing Code: 96136
- Insurance Median: $118
- Cash Discount Price: $85
- vs. Medicare Baseline: 0.87x 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 $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.
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 | $91 | 67% |
| UnitedHealthcare | $101 - $130 | 74% |
| Health Partners Of Kansas | $103 | 76% |
| Aetna | $109 | 80% |
| Celtic Insurance Company | $118 | 87% |
| Choicecare | $121 | 89% |
| Healthy Blue | $122 | 90% |
Consumer Guidance & Cost Commentary
For the CPT code 96136, "Psychological testing evaluation," Pratt Regional Medical Center in Pratt, KS, lists a cash median price of $85.00, which is lower than the facility's gross charge of $121.00. While the facility's negotiated rates range from $91.00 to $130.00 depending on the insurer, these amounts are generally higher than the cash price. This pricing structure highlights a common billing dynamic where commercial insurance contracts often exceed cash-pay rates due to administrative overhead and contract dynamics. For patients with high-deductible plans, paying the cash price of $85.00 upfront may result in lower out-of-pocket costs compared to the insurance negotiated rates, provided the patient has not yet met their deductible. It is advisable to contact the hospital directly to confirm "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When evaluating the cost of this service, it is important to compare the facility's pricing against objective benchmarks rather than the inflated gross charges. The Medicare amount for this procedure is $135.93, which serves as a scientifically validated baseline for the true cost of care. The facility's cash rate of $85.00 is approximately 63% of the Medicare amount, while the median negotiated rate of $118.00 represents roughly 87% of the Medicare amount. This comparison demonstrates that the cash price is significantly lower than both the Medicare benchmark and the commercial negotiated rates. To ensure you are receiving fair pricing, patients should request an itemized bill to verify that no unbundled codes or services not rendered are included