CMS Price Transparency Data

Psychological testing evaluation

Facility: Montefiore Mount Vernon Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $166
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Montefiore Mount Vernon Hospital is $166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 1.22x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$166

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%)
Insurance Median: $166 (122%)
Ins. Median: $166 (122% 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.

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
Emblem $14 - $199 10%
Fidelis $14 - $166 10%
Healthfirst $14 - $166 10%
Medicaid / KanCare $14 10%
Wellcare $15 - $169 11%
Vnsny Choice $17 - $166 13%
Vnsny Select Health $17 13%
American Postal Workers $24 18%
UnitedHealthcare $24 - $166 18%
Metroplus $25 - $216 18%
Blue Cross Blue Shield $166 - $426 122%
Point Comfort $166 122%
Villagecaremax $166 122%
Centerlight $171 - $183 126%
Partners Health Plan $174 128%
Longevity $181 133%
Elderplan $183 135%
Humana $183 135%
Molina Healthcare Of Ny Affinity $229 168%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals