CMS Price Transparency Data

Psychological testing evaluation

Facility: Phelps Memorial Health Center

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $96
Cash Discount Price: $91
vs. Medicare Baseline: 0.71x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Phelps Memorial Health Center is $96. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.71x the Medicare baseline. Located in 1215 Tibbals St, Holdrege, NE.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$96

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: $91 (67%)

Insurance Median: $96 (71%)

Cash: $91 (67% of Medicare)

Ins. Median: $96 (71% 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
UnitedHealthcare	$41 - $286	30%
Aetna	$44 - $286	32%
Molina Mcaid - All Plans	$44	32%
6 Degrees Hlth - All Plans	$81	60%
Partners Hlth Alliance - All Plans	$81	60%
Cpi Benefit Group-All Plans	$91	67%
Providrs Care/Wppa - All Plans	$91	67%
Provider Network Of American - All Plans	$94	69%
Medica-All Other Plans	$95	70%
Blue Cross Blue Shield	$96 - $286	71%
Chi Health Partners - All Plans	$96	71%
First Health - All Plans	$96	71%
Midwest Ntwrk Alliance - All Plans	$96	71%
Va Ccn - All Plans	$285	210%
Good Samaritan Mcr Adv - All Plans	$286	210%
Medica Mcr Adv	$286	210%
Wellcare Mcr Adv - All Plans	$286	210%
Three Rivers - All Plans	$343	252%
Ambetter / Centene	$744	547%

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 $91.
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 Phelps Memorial Health Center 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.