CMS Price Transparency Data

Psychological testing by technician

Facility: Highland Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $78
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.17x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Highland Hospital is $78. 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 $456.4, this hospital’s rate is 0.17x the Medicare baseline. Located in 1000 South Avenue, Rochester, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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%)

Insurance Median: $78 (17%)

Ins. Median: $78 (17% 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
Medicaid / KanCare	$18 - $1,190	4%
Aetna	$27 - $614	6%
Excellus Bc/Bs [2201]	$27 - $59	6%
Medicare (plans)	$27 - $654	6%
Elderplan [1316]	$32	7%
Humana	$32 - $609	7%
Icircle [1728]	$32	7%
Martins Point [1205]	$32 - $558	7%
Nascentia [1729]	$32	7%
UnitedHealthcare	$32 - $1,190	7%
Highmark Bc/Bs Of Western Ny [5143]	$35 - $41	8%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401]	$36 - $110	8%
Fidelis [5155]	$39 - $1,190	9%
Independent Health [5156]	$56 - $68	12%
Mvp [2900]	$58 - $1,332	13%
Cigna	$76 - $1,474	17%
Capital District Physicians Health Plan (Cdphp) [5149]	$82 - $110	18%
Amerigroup (Bswny Alternate) [1720]	$153 - $1,190	34%
Excellus [2201]	$153 - $917	34%
Molina Healthcare [5189], Molina Healthcare [1723]	$390 - $1,190	85%
Blue Cross Blue Shield	$558 - $795	122%

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 $X.
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 Highland Hospital 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.