CMS Price Transparency Data

Psychological testing evaluation

Facility: UPMC Chautauqua at Wca

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $170
Cash Discount Price: $157
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at UPMC Chautauqua at Wca is $170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $157. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 1.25x the Medicare baseline. Located in 207 Foote Avenue, Jamestown, NY.

Cash / Self-Pay

$157

Average discount available for prompt cash payment at this facility.

Insurance Median

$170

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: $157 (116%)

Insurance Median: $170 (125%)

Cash: $157 (116% of Medicare)

Ins. Median: $170 (125% 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
Univera	$25 - $143	18%
Upmc Health Plan	$25 - $157	18%
Independent Health	$26 - $33	19%
Geisinger	$28	21%
Health Partners Plans (Jefferson Health Plan)	$30	22%
Aetna	$37 - $170	27%
Fidelis	$37 - $307	27%
Beacon	$136	100%
Blue Cross Blue Shield	$136 - $227	100%
Molina Healthcare Of Ny	$136 - $307	100%
UnitedHealthcare	$136 - $170	100%
Corvel	$184	135%
Humana	$196 - $210	144%
Magnacare	$196	144%
Multiplan	$196	144%
Ghi/Emblem Health	$210	154%
Statewide Independent Ppo	$231	170%
Affordable First Health	$236	174%

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 $157.
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 UPMC Chautauqua at Wca 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.