CMS Price Transparency Data

Psychological testing evaluation

Facility: North Carolina Baptist Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $21
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 0.15x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at North Carolina Baptist Hospital is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.15x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$21

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: $30 (22%)
Insurance Median: $21 (15%)
Cash: $30 (22% of Medicare)
Ins. Median: $21 (15% 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.

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
Medcost $11 - $41 8%
Blue Cross Blue Shield $12 - $125 9%
Alliance $13 - $14 10%
Amerihealth $13 - $16 10%
Carolina Complete $13 - $14 10%
Health Blue $13 - $14 10%
Partners $13 - $14 10%
Trillium $13 - $14 10%
UnitedHealthcare $13 - $125 10%
Vaya $13 - $14 10%
Wellcare $13 - $125 10%
Aetna $14 - $125 10%
Ambetter / Centene $15 - $16 11%
Cigna $17 - $125 13%
Oscar $17 - $22 13%
Humana $31 - $126 23%
Directnet $34 - $36 25%
Cone Health $40 - $43 29%
Healthgram $40 - $43 29%
First Carolina Care $46 - $49 34%
Private Healthcare Systems $47 - $50 35%
Multiplan $51 - $55 38%
Apex $125 92%
Devoted $125 92%
Healthteam $125 92%
Medicare (plans) $126 93%
Liberty $143 105%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals