CMS Price Transparency Data

Psychological testing evaluation

Facility: Gillette Childrens Specialty Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $108
Cash Discount Price: $115
vs. Medicare Baseline: 0.79x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Gillette Childrens Specialty Hospital is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.79x the Medicare baseline. Located in 200 University Avenue East, Saint Paul, MN.

Cash / Self-Pay

$115

Average discount available for prompt cash payment at this facility.

Insurance Median

$108

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: $115 (85%)

Insurance Median: $108 (79%)

Cash: $115 (85% of Medicare)

Ins. Median: $108 (79% 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
Health Partners	$27 - $139	20%
Blue Cross Blue Shield	$36 - $135	26%
UnitedHealthcare	$39 - $115	29%
Medica	$77 - $142	57%
Ucare	$77 - $102	57%
Humana	$115	85%
Aetna	$134 - $144	99%
America'S Ppo	$154	113%
Geha	$163	120%
Multiplan	$163	120%

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 $115.
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 Gillette Childrens Specialty 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.