Psychological testing evaluation
Facility: Children'S Mercy South
Billing Code: 96136 (CPT)
- CPT Billing Code: 96136
- Insurance Median: $57
- Cash Discount Price: $50
- vs. Medicare Baseline: 0.42x 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 |
|---|---|---|
| Healthlink | $30 | 22% |
| Health Midwest Comprehensive Care | $32 | 24% |
| American Healthcare Alliance | $33 | 24% |
| Wellfit/Centrus | $44 | 32% |
| Centivo | $46 | 34% |
| Nebraska Furniture Mart | $46 | 34% |
| UnitedHealthcare | $49 - $87 | 36% |
| Wppa Providrs Care | $50 | 37% |
| Cigna | $54 | 40% |
| Healthy Blue | $55 - $57 | 40% |
| Home State Health | $55 | 40% |
| Medicaid / KanCare | $58 | 43% |
| Medica | $61 | 45% |
| Mercy Health | $76 | 56% |
| Coxhealth Network | $77 | 57% |
| Blue Cross Blue Shield | $80 | 59% |
| National Preferred Provider Network | $92 | 68% |
Consumer Guidance & Cost Commentary
For the CPT code 96136, Psychological testing evaluation, at Children's Mercy South in Overland Park, KS, the facility's cash median price is $50.00, which is lower than the negotiated rates paid by most commercial payers. While the facility's negotiated rates range from $30 to $92 depending on the insurer, the cash price of $50.00 represents a significant discount compared to the typical in-network allowed amounts. For patients with high-deductible plans, paying the cash price upfront can be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash rate due to administrative overhead and contract structures. Additionally, patients should inquire about "prompt-pay" discounts, which can further reduce the final bill if paid in full within a short window, bypassing the standard insurance billing cycle.
The facility's pricing is also contextualized against federal benchmarks; the Medicare amount for this service is $135.93, which serves as a baseline for evaluating the facility's markup. Although the data does not provide specific state or county average comparisons for this exact procedure, the facility's cash rate of $50.00 is notably lower than the Medicare benchmark, suggesting a competitive pricing model. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is crucial to verify the status of all ancillary services and request an itemized bill to ensure no unbundled charges or errors are included. Always confirm self-pay or prompt-pay options before scheduling to avoid unexpected costs.