CMS Price Transparency Data
Psychological testing evaluation
Facility: St Charles Hospital
Billing Code: 96136 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 96136
- Insurance Median: $153
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at St Charles Hospital is $153. 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 1.13x the Medicare baseline. Located in 200 Belle Terre Road, Port Jefferson, NY.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$153
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: $153 (113%)
Ins. Median: $153 (113% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Affinity Health Plan | $14 - $32 | 10% |
| Beacon Health Options | $14 - $214 | 10% |
| Beacon Health Strategies | $14 - $214 | 10% |
| Centerlight Healthcare | $14 - $153 | 10% |
| Elderplan Inc. | $14 - $153 | 10% |
| Emblem Health | $14 - $343 | 10% |
| Fidelis Care New York | $14 - $153 | 10% |
| Health First | $14 - $343 | 10% |
| Health Plus | $14 - $153 | 10% |
| Independent Health | $14 - $153 | 10% |
| Medicaid / KanCare | $14 | 10% |
| Mvp Health Plans | $14 - $153 | 10% |
| Senior Whole Health | $14 - $153 | 10% |
| UnitedHealthcare | $14 - $298 | 10% |
| Zadroga | $40 | 29% |
| Surest | $88 | 65% |
| Oscar Health | $120 | 88% |
| Aetna | $146 - $153 | 107% |
| Apwu | $146 | 107% |
| Brighton | $146 - $205 | 107% |
| Centivo | $146 | 107% |
| Cigna | $146 - $190 | 107% |
| Daniel H Cook | $146 | 107% |
| Mail Handlers Benefit Plan | $146 | 107% |
| Meritain Health | $146 | 107% |
| Nalc | $146 | 107% |
| Nippon Life Insurance Company Of America | $146 | 107% |
| Salvation Army | $146 | 107% |
| Samba | $146 | 107% |
| Blue Cross Blue Shield | $149 - $298 | 110% |
| Centers Plan For Healthy Living | $153 | 113% |
| Healthspring | $153 | 113% |
| Liberty Health | $153 | 113% |
| Longevity Health Plan | $153 | 113% |
| Medicare (plans) | $153 - $160 | 113% |
| Orthonet - Uniformed Services Family Health Plan | $153 | 113% |
| Pmc | $153 | 113% |
| Tricare | $153 | 113% |
| Universal Healthcare | $153 | 113% |
| Us Family Health Plan | $153 | 113% |
| Veterans Affairs | $153 | 113% |
| Humana | $156 | 115% |
| Agewell New York | $158 | 116% |
| Partners Health Plan | $160 | 118% |
| Wellcare Health Plan Inc | $168 | 124% |
| Allied Wellfare Fund | $190 | 140% |
| American Group Administrators | $190 | 140% |
| Bakery & Confectionery Union | $190 | 140% |
| Comprehensive Benefits Consultant | $190 | 140% |
| Guardian Life Insurance Company Of America | $190 | 140% |
| Maloney And Assoc | $190 | 140% |
| Multiplan | $190 | 140% |
| Performax | $190 | 140% |
| Phcs | $190 | 140% |
| Pomco | $190 | 140% |
| Tpa Inc | $190 | 140% |
| Unicare | $190 | 140% |
| United Employees Health Plan | $190 | 140% |
| Local 1199 | $216 | 159% |
| Coventry | $217 - $249 | 160% |
| Magellan | $234 | 172% |
| Galaxy | $264 | 194% |
| Three Rivers Provider Network | $264 | 194% |
| Aither Health | $293 | 216% |
| Alpha Care | $293 | 216% |
| Dentaquest | $293 | 216% |
| Self Pay | $298 | 219% |
| American Plan Administrators | $343 | 252% |
| Amerihealth Administrators | $343 | 252% |
| Benefit Services | $343 | 252% |
| Ghi Cbp Ny City Employee Alternate | $343 | 252% |
| International Benefit Administrator | $343 | 252% |
| Ultra Benefits Inc. | $343 | 252% |