CMS Price Transparency Data

Psychological testing evaluation

Facility: Perham Health

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $50
Cash Discount Price: $91
vs. Medicare Baseline: 0.37x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Perham Health is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.37x the Medicare baseline. Located in 1000 Coney Street West, Perham, MN.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$50

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: $91 (67%)

Insurance Median: $50 (37%)

Cash: $91 (67% of Medicare)

Ins. Median: $50 (37% 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
Blue Cross Blue Shield	$39 - $95	29%
Health Partners Mcr Adv	$48	35%
Humana	$48	35%
Medica Mcr Adv	$48	35%
Medicare (plans)	$48 - $53	35%
Ucare Mn Senior Health Options	$48	35%
UnitedHealthcare	$49 - $109	36%
Medicaid / KanCare	$50	37%
Ucare Mn Medical Assistance	$50	37%
Ucare Mn Minnesota Care	$50	37%
Ucare Mn Senior Care Plus	$50	37%
Ucare Mn Special Needs Basic Care	$50	37%
Ucare Mn Special Needs Basic Care Dual	$50	37%
Medica Mcaid Mn Care	$51	38%
Medica Mn (Msho)	$58	43%
Ucare Individual And Family Plan-All Other Plans	$58	43%
Health Partners Minnesota Care	$70	51%
Medica Commercial-All Other Plans	$102	75%
Preferred One (Pchp, Pic, Pas)-All Other Plans	$105	77%
Health Partners-All Plans	$115	85%
Preferred One (Ppo)	$119	88%
Sanford Health Plan-All Plans	$119	88%

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 $91.
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 Perham Health 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.