CMS Price Transparency Data
Psychological testing evaluation
Facility: Trinity Health Muskegon Hospital
Billing Code: 96136 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 96136
- Insurance Median: $25
- Cash Discount Price: $21
- vs. Medicare Baseline: 0.18x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Trinity Health Muskegon Hospital is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.18x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$21
Average discount available for prompt cash payment at this facility.
Insurance Median
$25
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$135.93
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $135.93 (100%)
Cash / Self-Pay: $21 (15%)
Insurance Median: $25 (18%)
Cash: $21 (15% of Medicare)
Ins. Median: $25 (18% of 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.
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 |
|---|---|---|
| Aetna | $14 - $22 | 10% |
| Bcn Domestic | $16 | 12% |
| Blue Benefit Administrators Of Massachusetts | $16 | 12% |
| Blue Care Network | $16 | 12% |
| Blue Cross Blue Shield | $16 | 12% |
| Blue Distinction Transplant | $16 | 12% |
| Blue Shield - Ca | $16 | 12% |
| Blue Shield - Id (Regence) | $16 | 12% |
| Blue Shield - Ny Highmark Northeastern | $16 | 12% |
| Blue Shield - Ny Highmark Western | $16 | 12% |
| Blue Shield - Pa (Highmark) | $16 | 12% |
| Blue Shield - Wa (Regence) | $16 | 12% |
| Health Choices | $16 - $26 | 12% |
| Kaiser Domestic | $16 | 12% |
| Acs Benefit Services | $17 | 13% |
| Allied Benefit Systems | $17 | 13% |
| Claimchoice Adminstrators | $17 | 13% |
| Consociate | $17 | 13% |
| Cypress Benefit Administrators | $17 | 13% |
| Forest County Potawatomi | $17 | 13% |
| Health Smart | $17 | 13% |
| Healthgram | $17 | 13% |
| Healthscope | $17 | 13% |
| Preferred One | $17 | 13% |
| Secureone Preferred United Plans | $17 | 13% |
| Sisco Benefits | $17 | 13% |
| The Health Plan | $17 | 13% |
| Trustmark Small Business Benefits | $17 | 13% |
| Unified Group Services | $17 | 13% |
| Webtpa | $17 | 13% |
| Asr Health Benefits | $18 | 13% |
| Hap | $18 - $26 | 13% |
| Hospice Of Michigan | $18 | 13% |
| Nomi Health | $18 | 13% |
| Wc Accident Fund | $18 | 13% |
| Wc Advantage | $18 | 13% |
| Wc Aig | $18 | 13% |
| Wc Allied | $18 | 13% |
| Wc Amerisure | $18 | 13% |
| Wc Amtrust | $18 | 13% |
| Wc Asu Risk Mgt | $18 | 13% |
| Wc Berkley Admin | $18 | 13% |
| Wc Broadspire | $18 | 13% |
| Wc Bunch & Associates | $18 | 13% |
| Wc Ccmsi | $18 | 13% |
| Wc Emc Insurance Company | $18 | 13% |
| Wc Esis | $18 | 13% |
| Wc Fcci | $18 | 13% |
| Wc Federated | $18 | 13% |
| Wc Gallagher Bassett | $18 | 13% |
| Wc Genex Care For Ohio | $18 | 13% |
| Wc Guard Insurance Company | $18 | 13% |
| Wc Hartford | $18 | 13% |
| Wc Liberty Mutual | $18 | 13% |
| Wc Meijers | $18 | 13% |
| Wc Michigan | $18 | 13% |
| Wc Mitchell Frankenmuth | $18 | 13% |
| Wc Pma | $18 | 13% |
| Wc Sedgwick | $18 | 13% |
| Wc Sentry | $18 | 13% |
| Wc Travelers | $18 | 13% |
| Wc Tristar | $18 | 13% |
| Wc Walmart | $18 | 13% |
| Wc Zurich | $18 | 13% |
| Varipro | $19 | 14% |
| Caresource | $21 | 15% |
| Cigna | $21 | 15% |
| Geha | $22 - $29 | 16% |
| Meritain | $22 | 16% |
| Priority Health | $22 | 16% |
| 1199 National Benefit Fund | $25 | 18% |
| Allied National Global Care | $25 | 18% |
| Asrm - Reliance Standard Life Insurance | $25 | 18% |
| Christian Care Ministry | $25 | 18% |
| Dean Health | $25 | 18% |
| Fallon Health | $25 | 18% |
| Family Life Insurance Company | $25 | 18% |
| Ghc Scw | $25 | 18% |
| Group Pension Administrators | $25 | 18% |
| International Benefit Administrators | $25 | 18% |
| Lifetime Benefit Solutions | $25 | 18% |
| Manhattan Life | $25 | 18% |
| Medi Share | $25 | 18% |
| Multiplan | $25 | 18% |
| Mvp | $25 | 18% |
| Pai | $25 | 18% |
| Pan-American Life | $25 | 18% |
| Paramount Hmo | $25 | 18% |
| Phcs | $25 | 18% |
| Trinity Health Share | $25 | 18% |
| Acclaim | $26 | 19% |
| Administrative Concepts | $26 | 19% |
| Allegeant | $26 | 19% |
| Ameriben | $26 | 19% |
| American Family | $26 | 19% |
| American Healthcare Alliance | $26 | 19% |
| American Republic | $26 | 19% |
| Amerihealth | $26 | 19% |
| Aultcare | $26 | 19% |
| Automated Benefit Services | $26 | 19% |
| Auxiant | $26 | 19% |
| Benefit Administrative Systems,Llc | $26 | 19% |
| Boon Chapman | $26 | 19% |
| Cam Administrative Services | $26 | 19% |
| Christian Brother Services | $26 | 19% |
| Christian Brothers Holy Cross | $26 | 19% |
| Comprehensive Benefits | $26 | 19% |
| Continental Life Insurance | $26 | 19% |
| Custom Benefit Administrators | $26 | 19% |
| Employee Benefit Concepts | $26 | 19% |
| Employee Benefit Management | $26 | 19% |
| Enterprise Group Planning | $26 | 19% |
| Freedom Life Insurance Company | $26 | 19% |
| Group Administrators | $26 | 19% |
| Group Marketing Services | $26 | 19% |
| Guardian | $26 | 19% |
| Health America | $26 | 19% |
| Healthez | $26 | 19% |
| Humana | $26 | 19% |
| Insight | $26 | 19% |
| Intercare | $26 | 19% |
| Jfp Benefit Management | $26 | 19% |
| Jp Farley Corporation | $26 | 19% |
| Key Benefit Administrator | $26 | 19% |
| Liberty Union Life Assurance Co | $26 | 19% |
| Lucent Health | $26 | 19% |
| Luminare Health | $26 | 19% |
| Luminare Health (Detroit) | $26 | 19% |
| Medben | $26 | 19% |
| Medcost | $26 | 19% |
| Medical Mutual | $26 | 19% |
| Mutual Health Services | $26 | 19% |
| Mutual Of Omaha | $26 | 19% |
| Ncas | $26 | 19% |
| Nippon Life Ins | $26 | 19% |
| Nova | $26 | 19% |
| Painters Union Insurance Fund | $26 | 19% |
| Physicians Mutual | $26 | 19% |
| Plumbers Local 98 Insurance Fund | $26 | 19% |
| Prairie States | $26 | 19% |
| Primary Physician Care | $26 | 19% |
| Professional Benefit Administrators | $26 | 19% |
| The Loomis Company | $26 | 19% |
| U Of M Health Plan | $26 - $83 | 19% |
| Unicare | $26 | 19% |
| Us Health And Life | $26 | 19% |
| Valenz | $26 | 19% |
| Western & Southern Financial Group | $26 | 19% |
| Wps | $26 | 19% |
| First Health | $27 | 20% |
| UnitedHealthcare | $29 | 21% |
| Barinet | $33 | 24% |
| Cmh Allegan County | $33 | 24% |
| Cmh Barry County | $33 | 24% |
| Cmh Berrien County | $33 | 24% |
| Cmh Cass County | $33 | 24% |
| Cmh Kalamazoo | $33 | 24% |
| Cmh Kent County | $33 | 24% |
| Cmh Misc | $33 | 24% |
| Cmh Muskegon County | $33 | 24% |
| Cmh North Country | $33 | 24% |
| Cmh Northern Lakes County | $33 | 24% |
| Cmh Ottawa County | $33 | 24% |
| Cmh Van Buren County | $33 | 24% |
| Cmh West Mi County | $33 | 24% |