CMS Price Transparency Data

Psychological testing evaluation

Facility: Pine Rest Christian Mental Health Services

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $40
Cash Discount Price: $81
vs. Medicare Baseline: 0.29x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Pine Rest Christian Mental Health Services is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.29x the Medicare baseline. Located in 300 - 68Th Street, Se, Grand Rapids, MI.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

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: $81 (60%)

Insurance Median: $40 (29%)

Cash: $81 (60% of Medicare)

Ins. Median: $40 (29% 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	$11 - $31	8%
UnitedHealthcare	$11 - $49	8%
Aetna	$15 - $81	11%
Blue Cross Blue Shield	$15 - $69	11%
Champva [1117]	$23 - $40	17%
Humana	$23 - $40	17%
Medicare (plans)	$23 - $40	17%
Molina [1156]	$23 - $40	17%
Tricare	$23 - $40	17%
Veterans Administration [1174]	$23 - $40	17%
University Of Michigan Health Plan Comm [1159]	$26 - $35	19%
University Of Michigan Health Plan [1205]	$26 - $35	19%
Mclaren Health Plan [1149]	$36	26%
Beacon/Carelon Behavioral Health [1198]	$43	32%
Golden Rule [1131]	$49	36%
Healthscope Benefits [1140]	$49	36%
Ubh [1167]	$49	36%
Asr Physicians Care Health Plan [1160]	$51 - $61	38%
Hap Ppo/Health Alliance Plan [1134]	$51 - $61	38%
Blue Care Network [1000]	$55 - $62	40%
Behavioral Health Systems [1115]	$60	44%
Priority Health [1300]	$60 - $92	44%
Cofinity [1120]	$61 - $81	45%
Geha [1129]	$61 - $81	45%
Meritain Health Plan [1153]	$61 - $81	45%
Compsych [1122]	$75	55%
Cigna	$79	58%

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 $81.
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 Pine Rest Christian Mental Health Services 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.