Psychological testing evaluation
Facility: Cloud County Health Center
Billing Code: 96136 (CPT)
- CPT Billing Code: 96136
- Insurance Median: $122
- Cash Discount Price: $91
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| Mpi-All Plans | $29 - $124 | 21% |
| Pponext-All Plans | $43 - $166 | 32% |
| Aetna | $117 - $121 | 86% |
| Health Partners - All Plans | $124 | 91% |
Consumer Guidance & Cost Commentary
For the CPT code 96136, "Psychological testing evaluation," Cloud County Health Center in Concordia, KS, lists a cash median price of $91.00, which is lower than the facility's negotiated rates of $122.00 to $124.00 across four major payers. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated amounts exceed the cash rate. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, this specific service does not guarantee that insurance will pay less than the cash price; in fact, administrative costs often inflate the allowed amount above the self-pay rate.
To ensure you are receiving the most accurate pricing, we recommend requesting an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Additionally, since the facility offers a cash median of $91.00, you should explicitly ask for a "prompt-pay" discount if you choose to settle the bill upfront, which can further reduce the total cost. Always verify your specific plan's deductible status and allowed amounts before scheduling, as assuming that in-network coverage automatically provides the lowest price can lead to unexpected costs if your plan has not yet met its deductible threshold.