CMS Price Transparency Data

Psychological testing evaluation

Facility: Mercy Medical Center

Billing Code: 96136 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$93

about 0.7× the $136 Medicare rate · typically $47–$186

modeled estimate · not a bill or quote

What this hospital charges insurers

$95

About the fair price

about $2 over the fair price · 0.7× Medicare

Medicare pays $136 Fair price $93 This hospital $95 Hospital's list price $293

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $23 Priciest $95

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

A fair price for a Psychological testing evaluation is about $93 (about 0.7× the $136 Medicare rate). Mercy Medical Center charges insurers about $95 — about the fair price. Located in Rockville Centre, NY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$14 - $298	10%
Blue Cross Blue Shieldmajor	$149 - $298	110%
Aetnamajor	$146 - $234	107%
Cignamajor	$146 - $190	107%
Humanamajor	$156	115%
AmeriHealth	$343	252%
Cigna HealthSpring	$153	113%
Fidelis Care	$14 - $153	10%
Independent Health	$14 - $153	10%
MVP Health Care	$14 - $153	10%
Oscar Health	$120	88%
UniCare	$190	140%
WellCare	$168	124%
+ 44 smaller / regional plans	$14 - $343

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 7 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 96136.

Insurance Before you use insurance

Call your insurance company to confirm Mercy Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 96136.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

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Other Procedures at Mercy Medical Center

Compare: Psychological testing evaluation at other NY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.