CMS Price Transparency Data

Psychological testing evaluation

Facility: Metropolitan Hospital Center

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $197
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Metropolitan Hospital Center is $197. 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 1.45x the Medicare baseline. Located in 1901 First Avenue, New York, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$197

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: $197 (145%)
Ins. Median: $197 (145% 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
Healthfirst $20 - $435 15%
Aetna $21 - $257 15%
Wellcare $28 21%
Carelon $49 - $193 36%
United Behavioral Health $55 - $213 40%
Blue Cross Blue Shield $153 - $435 113%
Elderplan $153 113%
Vaccn $153 113%
Vnsny $153 - $197 113%
Centers Plan For Healthy Living $159 117%
United $159 - $242 117%
Metroplus $177 - $435 130%
Oxford $184 135%
Amidacare $193 142%
Fidelis $193 - $435 142%
Senior Whole Health $193 142%
Affinity $197 - $435 145%
Carelon (Amida Care) $197 145%
Oscar $229 168%
Emblem $242 - $261 178%
Centerlight $254 187%
Magnacare $374 - $394 275%
Cigna $381 280%
Multiplan $407 299%
Local 1199 $432 318%
Villagecare Max $432 318%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 First Avenue, New York, NY 10029
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals