Psychological testing by technician
Facility: Wesley Medical Center
Billing Code: 96138 (CPT)
- CPT Billing Code: 96138
- Insurance Median: $134
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.29x 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 |
|---|---|---|
| UnitedHealthcare | $129 | 28% |
| Medicaid / KanCare | $133 | 29% |
| Aetna | $134 | 29% |
| Amerigroup | $134 | 29% |
Consumer Guidance & Cost Commentary
For the CPT code 96138, "Psychological testing by technician," at Wesley Medical Center in Wichita, KS, the facility's negotiated rates range from $129 to $134 across four payers, including UnitedHealthcare, Medicaid/KanCare, Aetna, and Amerigroup. These negotiated amounts align closely with the statewide average for this service, which is $134.00. While the facility's cash and median paid rates are not currently listed, patients with high-deductible plans should note that paying cash upfront can sometimes be more cost-effective if the insurance negotiated rate exceeds the cash price. It is important to contact the hospital directly to confirm if a "self-pay" or "prompt-pay" discount is available, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative processing fees.
The facility's pricing is benchmarked against the federal Medicare rate of $456.40, showing a variance of 30% below the standard Medicare reimbursement amount. This indicates that the facility's commercial rates are competitively priced relative to the government baseline, which often serves as the most transparent measure of true service cost. However, patients should be aware that balance billing is generally prohibited for in-network services under the No Surprises Act, meaning they should not be billed for the difference between the facility's chargemaster and the insurance allowed amount. To ensure accuracy, consumers are encouraged to request a detailed, itemized bill before paying, as summary invoices may obscure specific charges or unbundled codes that could lead to unexpected costs.