CMS Price Transparency Data

Psychological testing by technician

Facility: Mercy Hospital St Louis

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96138
  • Insurance Median: $23
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 0.05x Medicare
The contracted insurance negotiated median rate for a Psychological testing by technician at Mercy Hospital St Louis is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.05x the Medicare baseline. Located in 615 New Ballas Road, Saint Louis, MO.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$456.4

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $456.4 (100%)
Cash / Self-Pay: $35 (8%)
Insurance Median: $23 (5%)
Cash: $35 (8% of Medicare)
Ins. Median: $23 (5% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $456.4 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
Medicaid / KanCare $8 - $15 2%
Medica Contracted [320239] $14 - $679 3%
Ambetter / Centene $15 3%
Home State Health Plan Contracted [320187] $15 3%
Novasys Contracted [320285] $15 3%
Aetna $19 4%
Aither Health Contracted [320449] $23 5%
Aither Health [20449] $23 5%
Auxiant Contracted [320462] $23 5%
Ebms Contracted [320493] $23 5%
Edison Health Solutions Contracted [320502] $23 5%
Healthlink Contracted [320179] $23 - $37 5%
Imagine 360 Contracted [320494] $23 5%
Mercy Benefit Admin Contracted [320251] $23 - $24 5%
Mercy Benefit Admin [20251] $23 - $24 5%
Reflect Health Contracted [320492] $23 5%
Show-Me Health Administrators Contracted [320483] $23 5%
Yuzu Health Contracted [320521] $23 5%
Cigna $24 - $41 5%
Blue Cross Blue Shield $26 - $162 6%
Health Choices Contracted [320448] $32 7%
Health Choices [20448] $32 7%
Medical Associates Health Contracted [320444] $32 7%
Federal Medical Center Contracted [320127] $35 8%
Insurance System Inc Contracted [320465] $35 8%
Point C Contracted [320238] $35 8%
Tri State Healthcare Coalition Contracted [320379] $35 8%
First Health Contracted [320128] $38 8%
Mercy Mgd Behavioral Health Contracted [320259] $38 8%
Multiplan Contracted [320270] $38 - $40 8%
Private Health Care Systems Contracted [320320] $38 8%
Workers Comp [20426] $40 - $43 9%
Medicare (plans) $54 - $679 12%
UnitedHealthcare $591 - $726 129%
United Medical Resources Contracted [320454] $726 159%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 615 New Ballas Road, Saint Louis, MO 63141
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals