CMS Price Transparency Data

Psychological testing by technician

Facility: Mainehealth Maine Medical Center

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $39
Cash Discount Price: $36
vs. Medicare Baseline: 0.09x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Mainehealth Maine Medical Center is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.09x the Medicare baseline. Located in 22 Bramhall St, Portland, ME.

Cash / Self-Pay

$36

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$456.4

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $456.4 (100%)

Cash / Self-Pay: $36 (8%)

Insurance Median: $39 (9%)

Cash: $36 (8% of Medicare)

Ins. Median: $39 (9% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Harvard Pilgrim Healthcare	$27 - $66	6%
Aetna	$30 - $386	7%
Cigna	$31	7%
Community Health Options	$32 - $79	7%
Blue Cross Blue Shield	$34 - $1,754	7%
Multiplan	$34 - $67	7%
UnitedHealthcare	$34 - $386	7%
Humana	$36 - $386	8%
Wellcare	$39 - $398	9%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $36.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96138.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mainehealth Maine Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96138.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.