CMS Price Transparency Data

Psychological testing by technician

Facility: Atrium Health Cleveland

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $98
Cash Discount Price: $95
vs. Medicare Baseline: 0.21x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Atrium Health Cleveland is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.21x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.

Cash / Self-Pay

$95

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

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: $95 (21%)

Insurance Median: $98 (21%)

Cash: $95 (21% of Medicare)

Ins. Median: $98 (21% 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
Amerihealth Caritas	$27 - $31	6%
Carolina Complete Health	$27 - $31	6%
Healthy Blue	$27 - $31	6%
Partners	$27 - $31	6%
Wellcare	$27 - $31	6%
Alliance	$28 - $32	6%
Trillium	$28 - $31	6%
Vaya	$28 - $31	6%
Cigna	$31 - $393	7%
UnitedHealthcare	$31 - $395	7%
Aetna	$32 - $388	7%
Humana	$32 - $382	7%
Blue Cross Blue Shield	$59 - $97	13%
Ambetter / Centene	$61 - $69	13%
Choicecare	$78 - $156	17%
Employers Health Network	$84 - $133	18%
Medcost	$95 - $126	21%
Physician Reach Out	$95	21%
Magellan	$114	25%
Gmmi	$124 - $143	27%
Quik Trip	$124 - $143	27%
Carolina Behavioral Health	$137 - $152	30%
Healthgram	$145 - $152	32%
Multiplan	$152 - $181	33%
First Health	$162	35%
Lifesynch Community Choice Care	$162	35%
Private Health Care Systems	$171	37%
Beechstreet	$175	38%

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 $95.
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 Atrium Health Cleveland 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.