Psychological testing evaluation
Facility: Wamego Health 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% |
| Medicaid / KanCare | $43 - $54 | 32% |
| Providrs Care | $54 | 40% |
Consumer Guidance & Cost Commentary
For the CPT code 96136, "Psychological testing evaluation," at Wamego Health Center in Wamego, KS, the facility's negotiated rates range from $41 to $54 depending on the payer. This price point is notably higher than the state average, which sits at 30% above the Medicare benchmark of $135.93. While commercial payers like UnitedHealthcare and Aetna have fixed negotiated amounts of $41 and $43 respectively, Medicaid plans show a wider range of $43 to $54 across three different plans. Because commercial negotiated rates often include administrative overhead and do not reflect the true cost of care, patients with high-deductible plans might find that paying the cash price directly is more affordable than relying on insurance, provided the facility offers a self-pay or prompt-pay discount.
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, patients should still verify their specific plan details before scheduling. If a patient chooses to pay out-of-pocket, they should explicitly request a "self-pay" classification at registration to ensure they receive the lowest possible rate and avoid automatic claim submission that could void any cash discounts. Given that over 80% of hospital bills contain errors, patients should also insist on an itemized bill that breaks down every CPT code and charge, rather than accepting a summary invoice that may hide unbundled services or items not rendered. Always confirm the exact cash price and any prompt-pay incentives with the billing department prior to receiving services to ensure you are not paying the full chargemaster rate.