Psychological testing by technician
Facility: Wamego Health Center
Billing Code: 96138 (CPT)
- CPT Billing Code: 96138
- Insurance Median: $132
- 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 |
|---|---|---|
| Medicaid / KanCare | $32 - $134 | 7% |
| Providrs Care | $42 | 9% |
| UnitedHealthcare | $129 | 28% |
| Aetna | $134 | 29% |
Consumer Guidance & Cost Commentary
For the CPT code 96138, "Psychological testing by technician," the facility's negotiated rates range from $32 to $134 depending on the payer, with a median negotiated payment of $132.00. This facility is a Critical Access Hospital in Wamego, KS, and its pricing is significantly higher than the state average, which is indicated by a variance of 0.3 (30%) compared to Medicare rates. While commercial insurance contracts cap payments at these negotiated levels, patients with high-deductible plans may find that paying cash directly is more cost-effective, as the cash price could be lower than the insurance allowed amount. It is important to note that cash prices are not explicitly listed in this report, so patients should contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can often reduce the final bill by 20% to 50%.
Patients should be aware that the $132.00 median negotiated rate represents the maximum amount insurance carriers are contractually allowed to pay, not the full chargemaster price. Because this rate is often inflated by administrative costs and contract dynamics, it can exceed the true cost of care. If a patient receives care from an out-of-network provider, they could face balance billing for the difference between the provider's full list price and the insurance payment, though the No Surprises Act protects against this for emergency services and non-emergency care at in-network facilities. To avoid unexpected costs, consumers should request a detailed, itemized bill to verify that all services rendered are accurately coded and that no unbundled charges or services not received have been included. Disputing errors in writing is the