Psychological testing evaluation
Facility: Wesley Medical Center
Billing Code: 96136 (CPT)
- CPT Billing Code: 96136
- Insurance Median: $43
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.32x 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 |
|---|---|---|
| UnitedHealthcare | $41 | 30% |
| Aetna | $43 | 32% |
| Amerigroup | $43 | 32% |
| Medicaid / KanCare | $43 | 32% |
Consumer Guidance & Cost Commentary
For the CPT code 96136, "Psychological testing evaluation," at Wesley Medical Center in Wichita, KS, the facility's negotiated rate is $43.00. This amount aligns exactly with the lowest and highest negotiated rates reported by all four payers in this dataset, including UnitedHealthcare, Aetna, Amerigroup, and Medicaid/KanCare. While the facility is a Proprietary Acute Care Hospital, the data does not provide a specific cash or median paid amount for this service, so a direct comparison to the facility's own cash price cannot be made. However, patients should note that cash-pay options can sometimes be more cost-effective than insurance negotiated rates, particularly for those with high-deductible plans where the insurer's allowed amount might exceed the cash price. It is always advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower out-of-pocket costs.
When evaluating the cost of this service, it is important to understand that commercial insurance rates are often significantly higher than the Medicare benchmark. In this case, the Medicare amount for this procedure is $135.93, which serves as a scientifically validated baseline for the true cost of delivery. The negotiated rate of $43.00 is notably lower than the Medicare amount, indicating a favorable pricing structure compared to the federal government's reimbursement standard. Unlike the facility's chargemaster list, which is not provided here, comparing rates to the Medicare amount helps reveal the actual markup rather than being misled by inflated list prices. Since the data does not include state or county average comparisons, patients should rely on the Medicare benchmark and the specific