Psychological testing evaluation
Facility: Centura St. Catherine-Dodge City
Billing Code: 96136 (CPT)
- CPT Billing Code: 96136
- Insurance Median: $22
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.16x 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 |
|---|---|---|
| Medicare (plans) | $22 | 16% |
| Cigna | $22 | 16% |
| Humana | $22 | 16% |
| Kansas Health | $22 | 16% |
| Aetna | $22 | 16% |
| Blue Cross Blue Shield | $22 | 16% |
| Kaiser | $22 | 16% |
Consumer Guidance & Cost Commentary
For the CPT code 96136, Psychological testing evaluation, at Centura St. Catherine-Dodge City in Dodge City, KS, the negotiated rates across seven major payers are consistently $22.00. This amount is significantly lower than the Medicare benchmark of $135.93, which serves as the federal baseline for the true cost of this service. While commercial insurance contracts cap payments at $22.00, patients with high-deductible plans might find it financially advantageous to pay the cash price directly, as the cash rate is often lower than the insurance negotiated rate. However, since the cash median is not available in this dataset, patients should verify current cash pricing and inquire about self-pay or prompt-pay discounts before scheduling to ensure they are not paying more than necessary.
It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services like emergency physicians or specific lab tests are billed separately. If you receive a bill that appears to include services not rendered or charges that seem inflated, you should request a full itemized audit rather than accepting a summary bill. Since over 80% of hospital bills contain errors, asking for a line-by-line breakdown of CPT codes is the most effective way to identify double-billing or unbundled charges. Always dispute any discrepancies in writing to the billing supervisor to ensure your rights are protected and to avoid unnecessary debt.