CMS Price Transparency Data

Psychological testing evaluation

Facility: Raritan Bay Medical Center

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $141
Cash Discount Price: $143
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Raritan Bay Medical Center is $141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $143. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 1.04x the Medicare baseline. Located in 530 New Brunswick Ave, Perth Amboy, NJ.

Cash / Self-Pay

$143

Average discount available for prompt cash payment at this facility.

Insurance Median

$141

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: $143 (105%)

Insurance Median: $141 (104%)

Cash: $143 (105% of Medicare)

Ins. Median: $141 (104% 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
Aetna	$21 - $156	15%
Clover	$28	21%
Seoul Medical Group	$32	24%
Karna	$39	29%
Horizon	$67 - $152	49%
UnitedHealthcare	$92 - $956	68%
Qualcare	$104 - $143	77%
Activecare First McO	$118	87%
Bergen Risk	$118	87%
Cigna	$126 - $150	93%
Multiplan - PHCS	$133	98%
Amerihealth	$136 - $153	100%
Brighton Health Plan	$141	104%
Vaccn	$143	105%
Wellcare	$143	105%
Blue Cross Blue Shield	$143	105%
United Community/Americhoice	$150	110%
Amerigroup	$153	113%
Oxford	$389	286%

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 $143.
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 Raritan Bay Medical 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.