CMS Price Transparency Data

Psychological testing by technician

Facility: Sunrise Hospital and Medical Center

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $39
Cash Discount Price: $131
vs. Medicare Baseline: 0.09x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Sunrise Hospital and Medical Center is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.09x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.

Cash / Self-Pay

$131

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $131 (29%)

Insurance Median: $39 (9%)

Cash: $131 (29% of Medicare)

Ins. Median: $39 (9% 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
Humana	$24 - $34	5%
Amerigroup	$25 - $33	5%
Health Plan Nevada	$25 - $35	5%
Molina	$26 - $37	6%
Silver Summit	$26 - $42	6%
Healthcare Partners Of Nv	$33 - $44	7%
Aetna	$34 - $46	7%
Alignment Health Plan	$34	7%
Blue Cross Blue Shield	$34 - $67	7%
United	$34 - $196	7%
Caremore	$35	8%
Hometown Health Providers	$39 - $60	9%
Cigna	$42 - $77	9%
Sierra	$42 - $45	9%
Multiplan	$44	10%
Culinary Health Fund	$50	11%
Select Health	$65 - $77	14%
Legacy Provider Network	$175	38%
Corvel	$184 - $195	40%
Comp-Med Workers Comp	$188	41%
Olympus Medsave Usa	$194 - $206	43%

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 $131.
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 Sunrise Hospital and 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.