CMS Price Transparency Data

Psychological testing evaluation

Facility: Glens Falls Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $42
Cash Discount Price: $231
vs. Medicare Baseline: 0.31x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Glens Falls Hospital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $231. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.31x the Medicare baseline. Located in 100 Park Street, Glens Falls, NY.

Cash / Self-Pay

$231

Average discount available for prompt cash payment at this facility.

Insurance Median

$42

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: $231 (170%)

Insurance Median: $42 (31%)

Cash: $231 (170% of Medicare)

Ins. Median: $42 (31% 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
Medicaid / KanCare	$13 - $39	10%
Cdphp	$15 - $447	11%
Medicare (plans)	$17 - $39	13%
UnitedHealthcare	$17 - $389	13%
Emblem Health Ghi	$19 - $39	14%
Tricare	$19 - $39	14%
Blue Cross Blue Shield	$20 - $376	15%
Aetna	$22 - $154	16%
Fidelis	$22 - $447	16%
Mvp	$22 - $417	16%
Blue Shield	$33	24%
Cigna	$35 - $79	26%
Blue Shield Highmark	$48 - $58	35%
Magnacare	$153 - $344	113%
Mvp Commercial	$158 - $422	116%
Hamaspik	$298 - $348	219%
Nascentia Health Options	$298 - $348	219%
Emblem	$366 - $429	269%
Empire Plan Nyship	$376 - $456	277%
Multiplan	$389 - $456	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 $231.
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 Glens Falls Hospital 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.