CMS Price Transparency Data

Psychological testing evaluation

Facility: Essentia Health Virginia

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $127
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Essentia Health Virginia is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.93x the Medicare baseline. Located in 901 9Th Street North, Virginia, MN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$127

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%)
Insurance Median: $127 (93%)
Ins. Median: $127 (93% 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
Primewest $123 90%
Advocare/Security Health $127 93%
Blue Cross Blue Shield $127 - $454 93%
Freedom Blue Ppo $127 93%
Healthpartners Care Msho / Mcr Adv $127 93%
Imcare Msho Pcc Prime $127 93%
Imcare Msho Ref Req $127 93%
Medica Advantage Solutions $127 93%
Medica Msho/Dual Solutions $127 93%
Medica Prime Solution Group $127 93%
Medicare (plans) $127 93%
Nd Va Administration $127 93%
Platinum Blue/Vantage Blue $127 93%
Primewest Msho $127 93%
Secure Blue Msho $127 93%
Ubh Cost Plan $127 93%
Ubh Msho $127 93%
Ucare Msho $127 93%
UnitedHealthcare $127 93%
Itasca Med Care $129 95%
Sanford Healthplan $228 168%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 9Th Street North, Virginia, MN 55792
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals