CMS Price Transparency Data

Psychological testing by technician

Facility: The Children's Mercy Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $64
Cash Discount Price: $50
vs. Medicare Baseline: 0.14x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at The Children's Mercy Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.14x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $50 (11%)

Insurance Median: $64 (14%)

Cash: $50 (11% of Medicare)

Ins. Median: $64 (14% 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.

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
UnitedHealthcare	$32 - $69	7%
Healthy Blue	$34 - $43	7%
Medicaid / KanCare	$34	7%
Wppa Providrs Care	$38	8%
Home State Health	$43	9%
Healthlink	$44	10%
Health Midwest Comprehensive Care	$45	10%
American Healthcare Alliance	$47	10%
Medica	$61	13%
Wellfit/Centrus	$62	14%
Blue Cross Blue Shield	$64	14%
Centivo	$64	14%
Nebraska Furniture Mart	$69	15%
Mercy Health	$77	17%
Coxhealth Network	$78	17%
Cigna	$79	17%
National Preferred Provider Network	$92	20%

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 $50.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96138.

Insurance In-Network Protection Plan

Contact your insurance company to confirm The Children's Mercy Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96138.
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.