CMS Price Transparency Data

Psychological testing by technician

Facility: Southern Ocean Medical Center

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $488
Cash Discount Price: $436
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Southern Ocean Medical Center is $488. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $436. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 1.07x the Medicare baseline. Located in 1140 Rt 72 W, Manahawkin, NJ.

Cash / Self-Pay

$436

Average discount available for prompt cash payment at this facility.

Insurance Median

$488

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: $436 (96%)

Insurance Median: $488 (107%)

Cash: $436 (96% of Medicare)

Ins. Median: $488 (107% 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
Horizon	$21 - $570	5%
Karna	$59	13%
Clover	$112	25%
Aetna	$115 - $561	25%
Seoul Medical Group	$128	28%
UnitedHealthcare	$367 - $651	80%
Oxford	$396	87%
Blue Cross Blue Shield	$436	96%
Vaccn	$436	96%
Wellcare	$436	96%
United Community/Americhoice	$458	100%
Bergen Risk	$467	102%
Cigna	$498 - $596	109%
Multiplan - PHCS	$530	116%
Amerihealth	$541 - $613	119%
Brighton Health Plan	$561	123%
Qualcare	$566	124%

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 $436.
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 Southern Ocean Medical Center 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.