CMS Price Transparency Data

Psychological testing by technician

Facility: Suny/Stony Brook University Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $458
Cash Discount Price: $490
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Suny/Stony Brook University Hospital is $458. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $490. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 1.00x the Medicare baseline. Located in Health Sciences Center SUNY, Stony Brook, NY.

Cash / Self-Pay

$490

Average discount available for prompt cash payment at this facility.

Insurance Median

$458

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: $490 (107%)

Insurance Median: $458 (100%)

Cash: $490 (107% of Medicare)

Ins. Median: $458 (100% 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
Beacon Health Options	$35	8%
Aetna	$204 - $519	45%
Blue Cross Blue Shield	$204 - $509	45%
Elderplan	$204 - $509	45%
Fidelis Care	$204 - $509	45%
Healthfirst Health Plan	$204 - $509	45%
UnitedHealthcare	$204 - $4,255	45%
Emblemhealth Hip Of Ny	$208 - $519	46%
Agewell New York	$224 - $560	49%
Centerlight	$265 - $661	58%
Partners Health Plan	$265 - $661	58%

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 $490.
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 Suny/Stony Brook University 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.