Psychological testing evaluation
Facility: Ascension Via Christi Hospitals Wichita, Inc.
Billing Code: 96136 (CPT)
- CPT Billing Code: 96136
- Insurance Median: $120
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.88x 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 |
|---|---|---|
| Humana | $119 | 88% |
| Vc Hope | $119 | 88% |
| Saint Lukes Health Systems | $119 | 88% |
| Va | $119 | 88% |
| Via Christi Research | $119 | 88% |
| Medicare (plans) | $119 - $122 | 88% |
| UnitedHealthcare | $122 - $334 | 90% |
| Blue Cross Blue Shield | $122 | 90% |
| Corizon | $149 | 110% |
| Smarthealth | $167 | 123% |
| Medicaid / KanCare | $203 | 149% |
Consumer Guidance & Cost Commentary
For the CPT code 96136, Psychological testing evaluation, at Ascension Via Christi Hospitals Wichita, Inc., the negotiated rates range from $119 to $203 depending on the payer. The median negotiated rate is $120.00, which is lower than the facility's Medicare benchmark of $135.93, indicating a rate structure that aligns with fair pricing standards rather than inflated chargemaster lists. While commercial payers like UnitedHealthcare have negotiated rates as high as $334, many other insurers, including Humana and Medicaid/KanCare, pay the exact Medicare amount of $119 to $122. This suggests that for patients with high-deductible plans, paying cash or utilizing a prompt-pay discount could result in lower out-of-pocket costs compared to the commercial negotiated rates, as the administrative overhead and contract markups often inflate the insurance allowed amount.
Patients should be aware that hospitals frequently issue summary bills that obscure individual line items, making it difficult to identify errors such as unbundled codes or services not rendered. To ensure accurate billing, consumers should request a full itemized CPT-coded statement before finalizing payment, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to verify that all ancillary services, such as laboratory tests, are covered under the same network agreement to avoid unexpected charges. Given the facility's location in Wichita, KS, and its status as a voluntary non-profit acute care hospital, patients are encouraged to contact the billing