CMS Price Transparency Data

Psychological testing by technician

Facility: Harlem Hospital Center

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $231
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.51x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Harlem Hospital Center is $231. 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 0.51x the Medicare baseline. Located in 506 Lenox Avenue, New York, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$231

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: $231 (51%)

Ins. Median: $231 (51% 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
Healthfirst	$32 - $472	7%
Aetna	$35 - $257	8%
Carelon	$40 - $210	9%
Wellcare	$43	9%
United Behavioral Health	$45 - $231	10%
United	$159 - $262	35%
Oxford	$184	40%
Metroplus	$194 - $472	43%
Amidacare	$210	46%
Blue Cross Blue Shield	$210 - $529	46%
Fidelis	$210 - $671	46%
Senior Whole Health	$210	46%
Affinity	$214 - $472	47%
Carelon (Amida Care)	$214	47%
Vnsny	$214 - $472	47%
Emblem	$262 - $283	57%
Centerlight	$330	72%
Magnacare	$374 - $394	82%
Elderplan	$472	103%
Vaccn	$472	103%
Centers Plan For Healthy Living	$491	108%
Cigna	$496	109%
Multiplan	$529	116%
Local 1199	$562	123%
Villagecare Max	$562	123%
Oscar	$708	155%

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 Harlem Hospital Center 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.