CMS Price Transparency Data

Psychological testing evaluation

Facility: Holland Community Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $32
Cash Discount Price: $19
vs. Medicare Baseline: 0.24x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Holland Community Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.24x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.

Cash / Self-Pay

$19

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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: $19 (14%)

Insurance Median: $32 (24%)

Cash: $19 (14% of Medicare)

Ins. Median: $32 (24% 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.

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
Molina Mcaid - All Plans	$6 - $27	4%
Ph Mcaid	$6 - $27	4%
Nomi Health - All Plans	$11 - $84	8%
Aetna	$14 - $137	10%
Cofinity -All Plans	$14 - $59	10%
Multiplan - All Plans	$17 - $40	13%
Benefit Source Inc-All Plans	$18 - $42	13%
First Health-All Plans	$18 - $28	13%
Usa Managed Care-All Plans	$18	13%
Integrated Health Plans-All Plans	$19	14%
Life Circles-All Plans	$20 - $126	15%
UnitedHealthcare	$20 - $50	15%
Health Alliance Mcr Adv	$21 - $133	15%
Ph Mcr Adv	$21 - $133	15%
Va Ccn - All Plans	$21 - $133	15%
Longevity Health Plan-All Plans	$23 - $143	17%
Meridian Mcaid Profee Only-All Plans	$27	20%
Cigna	$31 - $38	23%
Priority Health - All Other Plans	$32 - $42	24%
Sisco Epi	$42	31%
Sisco-All Other Plans	$42	31%
Asr - All Plans	$54 - $314	40%
Health Alliance Ahl - All Other Plans	$54 - $314	40%
Health Alliance Hmo	$54 - $300	40%
Blue Care Network - All Plans	$63	46%
Blue Cross Blue Shield	$67	49%

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 $19.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96136.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Holland Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96136.
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.