CMS Price Transparency Data

Psychological testing evaluation

Facility: Atrium Health Union

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $69
Cash Discount Price: $115
vs. Medicare Baseline: 0.51x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Atrium Health Union is $69. 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 0.51x the Medicare baseline. Located in 600 Hospital Dr, Monroe, NC.

Cash / Self-Pay

$115

Average discount available for prompt cash payment at this facility.

Insurance Median

$69

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: $69 (51%)

Cash: $115 (85% of Medicare)

Ins. Median: $69 (51% 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
Amerihealth Caritas	$21 - $30	15%
Carolina Complete Health	$21 - $31	15%
Healthy Blue	$21 - $31	15%
Partners	$21 - $30	15%
Trillium	$21 - $32	15%
UnitedHealthcare	$21 - $129	15%
Vaya	$21 - $31	15%
Wellcare	$21 - $31	15%
Alliance	$22 - $36	16%
Cigna	$22 - $155	16%
Humana	$22 - $125	16%
Aetna	$23 - $140	17%
Ortho Carolina	$28 - $153	21%
Ambetter / Centene	$33 - $83	24%
Physician Reach Out	$38	28%
Blue Cross Blue Shield	$50 - $86	37%
Choicecare	$53 - $196	39%
Employers Health Network	$53 - $102	39%
Gmmi	$57 - $150	42%
Quik Trip	$57 - $150	42%
Healthgram	$58 - $184	43%
Multiplan	$61 - $218	45%
Medcost	$63 - $150	46%
First Health	$65 - $196	48%
Beechstreet	$69 - $207	51%
Private Health Care Systems	$69 - $207	51%
Provider Select	$69 - $207	51%
Magellan	$138	102%

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 Atrium Health Union 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.