Psychological testing by technician
Facility: University Of Kansas Hospital
Billing Code: 96138 (CPT)
- CPT Billing Code: 96138
- Insurance Median: $254
- Cash Discount Price: $75
- vs. Medicare Baseline: 0.56x 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 |
|---|---|---|
| Home State Health Plan [503201507] | $102 | 22% |
| Blue Cross Blue Shield | $105 - $289 | 23% |
| Larned State Hospital [503200090] | $111 | 24% |
| Hchsync Centrus Health Direct [503999916] | $113 - $132 | 25% |
| Alt Theramatrix [5032000967] | $155 | 34% |
| Health Plan Inc [503999941] | $177 | 39% |
| Cigna | $187 - $301 | 41% |
| Accarent Health [503999034] | $188 | 41% |
| Alt Carelon Behavioral Health [503200905] | $188 | 41% |
| Aetna | $194 - $254 | 43% |
| Coventry [503200022] | $194 - $254 | 43% |
| Meritain Health [503200039] | $194 - $316 | 43% |
| Coresource [503200089] | $194 | 43% |
| Workers Comp [503999901] | $196 - $357 | 43% |
| National Assn Letter Carriers [503200019] | $208 | 46% |
| Allied National [503999937] | $226 | 50% |
| Php [503200005] | $226 - $278 | 50% |
| Cerner [503200038] | $228 | 50% |
| Healthlink [503200007] | $228 - $278 | 50% |
| Geha [503200036] | $228 - $321 | 50% |
| Med-Pay [503200040] | $228 | 50% |
| Alt Wppa [5032000964] | $228 | 50% |
| Inter-Americas Insurance [503999032] | $228 | 50% |
| Alt Coventry Mhnet [503200030] | $229 | 50% |
| Mh Net [503999024] | $229 | 50% |
| Alt Coventry Advantra Mhnet [50311260] | $229 | 50% |
| First Health [5032000110] | $248 | 54% |
| Aha-Healthcare Preferred [503200050] | $248 | 54% |
| Alt Meritain Health [503999911] | $254 | 56% |
| Gallagher Bassett [5032000103] | $255 - $263 | 56% |
| Prime Health Services [503999912] | $258 | 57% |
| Ascension Living Hope [503201517] | $263 | 58% |
| Alt Bnsf Railway Co [503301503] | $263 | 58% |
| Coeur Plan Services [503301517] | $263 | 58% |
| Consolidated Billing [50311256] | $263 | 58% |
| Correct Care Solutions [50311253] | $263 | 58% |
| Sedgwick Claims Management Services [53201618] | $263 | 58% |
| Orscheln Industries [503201608] | $282 | 62% |
| Empire Plan/Nyship [503200705] | $289 | 63% |
| Alt Lineco [5032000976] | $289 | 63% |
| Alt Lucent Health Solutions [503202603] | $289 | 63% |
| Century Health Solutions [503200054] | $301 | 66% |
| Point Comfort Underwriters [503200018] | $301 | 66% |
| Quiktrip [5032000412] | $301 | 66% |
| Wppa [503200056] | $316 | 69% |
| Medica [503200074] | $321 | 70% |
| UnitedHealthcare | $321 | 70% |
| Sanford Health Plan [503999027] | $338 | 74% |
| Usa Managed Care [503999030] | $338 | 74% |
| Three Rivers Provider Network [503999029] | $338 | 74% |
| Employers Health Network [503999025] | $338 | 74% |
| Plan Care America [503999026] | $338 | 74% |
Consumer Guidance & Cost Commentary
For the CPT code 96138, representing psychological testing by a technician, the University of Kansas Hospital in Kansas City, KS, lists a gross charge of $376.00. While the facility's cash median rate is $75.00, commercial insurance negotiated rates vary significantly, ranging from a low of $102 to a high of $357 across 52 different payers. It is important to note that cash payments can sometimes be more cost-effective than using insurance, particularly for patients with high-deductible plans where the insurer's negotiated rate might exceed the cash price. Patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass administrative costs and lower the final amount owed.
When evaluating the financial impact of this service, it is crucial to compare rates against the Medicare benchmark rather than the hospital's inflated gross charge. The Medicare amount for this procedure is $456.40, which serves as the objective baseline for fair pricing. Although the facility's cash rate of $75.00 is lower than the Medicare benchmark, the wide variance in commercial negotiated rates—such as the range of $102 to $357 observed among major payers like Blue Cross Blue Shield and Cigna—highlights the importance of verifying specific allowed amounts. To ensure you are not overcharged, request a detailed, itemized billing audit to confirm that all charges align with the procedure performed and that no unbundled codes or services not rendered have been included in the final invoice.