CMS Price Transparency Data

Psychological testing by technician

Facility: Strong Memorial Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $76
Cash Discount Price: $894
vs. Medicare Baseline: 0.17x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Strong Memorial Hospital is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $894. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.17x the Medicare baseline. Located in 601 Elmwood Ave, Rochester, NY.

Cash / Self-Pay

$894

Average discount available for prompt cash payment at this facility.

Insurance Median

$76

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: $894 (196%)

Insurance Median: $76 (17%)

Cash: $894 (196% of Medicare)

Ins. Median: $76 (17% 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
Medicaid / KanCare	$18 - $1,190	4%
Aetna	$27 - $594	6%
Excellus Bc/Bs [2201]	$27 - $59	6%
Medicare (plans)	$27 - $654	6%
Elderplan [1316]	$32	7%
Humana	$32 - $609	7%
Icircle [1728]	$32	7%
Martins Point [1205]	$32 - $558	7%
Nascentia [1729]	$32	7%
UnitedHealthcare	$32 - $1,190	7%
Highmark Bc/Bs Of Western Ny [5143]	$35 - $41	8%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401]	$36 - $110	8%
Fidelis [5155]	$39 - $1,190	9%
Independent Health [5156]	$56 - $68	12%
Mvp [2900]	$58 - $1,659	13%
Cigna	$76 - $1,800	17%
Capital District Physicians Health Plan (Cdphp) [5149]	$82 - $110	18%
Blue Cross Blue Shield	$151 - $1,190	33%
Excellus [2201]	$179	39%
Molina Healthcare [5189]	$390	85%
Molina Healthcare [1723], Molina Healthcare [5189]	$1,190	261%

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 $894.
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 Strong Memorial Hospital 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.