CMS Price Transparency Data

Psychological testing evaluation

Facility: McLaren Northern Michigan

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $69
Cash Discount Price: $23
vs. Medicare Baseline: 0.51x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at McLaren Northern Michigan is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.51x the Medicare baseline. Located in 416 Connable Ave, Petoskey, MI.

Cash / Self-Pay

$23

Average discount available for prompt cash payment at this facility.

Insurance Median

$69

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: $23 (17%)

Insurance Median: $69 (51%)

Cash: $23 (17% of Medicare)

Ins. Median: $69 (51% 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
Medicaid / KanCare	$15 - $73	11%
Humana	$21 - $126	15%
Medicare (plans)	$21 - $201	15%
Hap - Hmo	$23	17%
U Of M Health Plan	$24	18%
Mclaren Commercial Ins	$26	19%
Aetna	$28	21%
UnitedHealthcare	$29	21%
Priority Health	$31	23%
Blue Cross Blue Shield	$67	49%
Tricare	$114	84%
Mi Amish Medical Board	$126	93%

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 $23.
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 McLaren Northern Michigan 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.