Psychological testing evaluation
Facility: Kingman Healthcare Center
Billing Code: 96136 (CPT)
- CPT Billing Code: 96136
- Insurance Median: $51
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.38x 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 |
|---|---|---|
| Triwest | $22 | 16% |
| Medicaid / KanCare | $51 | 38% |
| Healthy Blue | $51 | 38% |
Consumer Guidance & Cost Commentary
For the CPT code 96136, representing a psychological testing evaluation at Kingman Healthcare Center in Kansas, the facility's negotiated rates align precisely with the state average of $51.00 across all three payers, including Triwest, Medicaid/KanCare, and Healthy Blue. This consistency indicates that the facility is charging the standard rate expected for this service within the region, with no deviation from the local market norm. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the pricing remains transparent and uniform, offering predictability for patients relying on these specific insurance plans.
It is important to note that while the negotiated rate is $51.00, the Medicare benchmark for this service is significantly lower at $135.93. In many cases, paying cash directly can result in lower out-of-pocket costs compared to using insurance, particularly for patients with high deductibles, as the insurance negotiated rate often exceeds the cash price. Patients should proactively inquire about self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can further reduce the final bill. Additionally, if you receive a bill from an out-of-network provider or encounter unexpected charges, you have the right to request an itemized audit to verify that all services rendered are accurately coded and that no balance billing violations have occurred under federal protections.