CMS Price Transparency Data

Psychological testing evaluation

Facility: Saratoga Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $39
Cash Discount Price: $35
vs. Medicare Baseline: 0.29x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Saratoga Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.29x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.

Cash / Self-Pay

$35

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

$135.93

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.93 (100%)

Cash / Self-Pay: $35 (26%)

Insurance Median: $39 (29%)

Cash: $35 (26% of Medicare)

Ins. Median: $39 (29% 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 - $434	11%
Fidelis	$17 - $434	13%
Medicare (plans)	$17 - $39	13%
Blue Cross Blue Shield	$18 - $357	13%
Tricare	$19 - $39	14%
Hamaspik	$21 - $453	15%
Emblem Health Ghi	$22 - $43	16%
Mvp	$22 - $79	16%
UnitedHealthcare	$22 - $193	16%
Aetna	$23 - $156	17%
Nascentia Health Options	$34	25%
Cigna	$35 - $79	26%
Emblem	$35 - $153	26%
Mvp Commercial	$46 - $50	34%
Blue Shield Highmark	$48 - $60	35%
Multiplan	$50 - $56	37%
Empire Plan Nyship	$56	41%
Magnacare	$59 - $63	43%
Blue Shield	$66	49%
Mvp Essential Plan	$193 - $386	142%
Mvp Govt Programs	$193	142%

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 $35.
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 Saratoga 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.