CMS Price Transparency Data

Psychological testing evaluation

Facility: Strong Memorial Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $51
Cash Discount Price: $348
vs. Medicare Baseline: 0.38x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Strong Memorial Hospital is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $348. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.38x the Medicare baseline. Located in 601 Elmwood Ave, Rochester, NY.

Cash / Self-Pay

$348

Average discount available for prompt cash payment at this facility.

Insurance Median

$51

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%)

Cash / Self-Pay: $348 (256%)

Insurance Median: $51 (38%)

Cash: $348 (256% of Medicare)

Ins. Median: $51 (38% 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

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	$11 - $45	8%
Blue Cross Blue Shield	$14 - $290	10%
Excellus [2201]	$14	10%
Molina Healthcare [1723], Molina Healthcare [5189]	$14	10%
Molina Healthcare [5189]	$14	10%
UnitedHealthcare	$14 - $172	10%
Mvp [2900]	$17 - $536	13%
Aetna	$19 - $183	14%
Excellus Bc/Bs [2201]	$19 - $73	14%
Medicare (plans)	$19 - $211	14%
Elderplan [1316]	$22 - $39	16%
Humana	$22 - $195	16%
Icircle [1728]	$22 - $39	16%
Martins Point [1205]	$22 - $166	16%
Nascentia [1729]	$22 - $39	16%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401]	$25 - $136	18%
Fidelis [5155]	$27 - $53	20%
Independent Health [5156]	$37 - $85	27%
Highmark Bc/Bs Of Western Ny [5143]	$45 - $52	33%
Cigna	$53 - $581	39%
Capital District Physicians Health Plan (Cdphp) [5149]	$58 - $140	43%

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 $348.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96136.

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 96136.
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.