CMS Price Transparency Data

Psychological testing evaluation

Facility: Westfield Memorial Hospital Inc

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $40
Cash Discount Price: $15
vs. Medicare Baseline: 0.29x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Westfield Memorial Hospital Inc is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.29x the Medicare baseline. Located in 189 E Main St, Westfield, NY.

Cash / Self-Pay

$15

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

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: $15 (11%)

Insurance Median: $40 (29%)

Cash: $15 (11% of Medicare)

Ins. Median: $40 (29% 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
Univera	$19 - $28	14%
Amerihealth	$21 - $160	15%
Highmark	$21 - $253	15%
Life Pittsburgh	$22 - $153	16%
Medicare (plans)	$23 - $157	17%
American Health Plans	$24 - $153	18%
Pennsylvania Health And Wellness	$26 - $30	19%
Geisinger	$29 - $32	21%
UnitedHealthcare	$29 - $165	21%
Jefferson Health Plans	$31	23%
Cigna	$37	27%
Carelon	$40	29%
Community Care Behavorial Health Healthchoices	$60	44%
Community Care Behavorial Health University Of Pittsburgh Medical Center	$60	44%
Martin'S Point	$153	113%
Aetna	$159 - $293	117%
Humana	$162	119%
Molina	$166	122%

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 $15.
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 Westfield Memorial Hospital Inc 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.