CMS Price Transparency Data

Psychological testing by technician

Facility: Montefiore St Luke's Cornwall

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $558
Cash Discount Price: $558
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Montefiore St Luke's Cornwall is $558. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $558. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 1.22x the Medicare baseline. Located in 70 Dubois Street, Newburgh, NY.

Cash / Self-Pay

$558

Average discount available for prompt cash payment at this facility.

Insurance Median

$558

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%)

Cash / Self-Pay: $558 (122%)

Insurance Median: $558 (122%)

Cash: $558 (122% of Medicare)

Ins. Median: $558 (122% 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	$104 - $558	23%
Blue Cross Blue Shield	$125 - $753	27%
Emblem	$125 - $3,524	27%
Medicaid / KanCare	$125	27%
Hamaspik	$131 - $602	29%
Fidelis	$446 - $647	98%
Mediblue	$541	119%
Aetna	$552	121%
Affinity	$558 - $586	122%
Cdphp	$558	122%
Hudson Valley	$558	122%
Oscar	$558	122%
Point Comfort	$558	122%
UnitedHealthcare	$558	122%
Villagecaremax	$558	122%
Vnsny Choice	$558	122%
Centerlight	$574	126%
Wellcare	$574	126%
Humana	$613	134%
Northwell	$1,500	329%

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 $558.
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 Montefiore St Luke's Cornwall 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.