CMS Price Transparency Data

Psychological testing evaluation

Facility: Mercy Medical Center

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $119
Cash Discount Price: $171
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Mercy Medical Center is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $171. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.88x the Medicare baseline. Located in 1320 Mercy Drive Nw, Canton, OH.

Cash / Self-Pay

$171

Average discount available for prompt cash payment at this facility.

Insurance Median

$119

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: $171 (126%)

Insurance Median: $119 (88%)

Cash: $171 (126% of Medicare)

Ins. Median: $119 (88% 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
Summacare	$15 - $146	11%
United	$18 - $161	13%
Buckeye	$19 - $151	14%
Caresource	$19 - $151	14%
Amerihealth	$20 - $161	15%
Molina	$20 - $154	15%
Aetna	$22 - $263	16%
Blue Cross Blue Shield	$22 - $169	16%
Cigna	$22 - $137	16%
Humana	$22 - $119	16%
The Health Plan	$22 - $263	16%
Communicare	$23 - $125	17%
Mmo	$23 - $242	17%
Perennial Health	$24 - $129	18%
Zing Health	$25 - $131	18%
Aultcare	$26 - $108	19%
Oscar	$63 - $101	46%
Ohcp	$92 - $128	68%
Cc Ehp	$105 - $107	77%
Amish Community Aid Plan	$118 - $132	87%
Omas	$118 - $132	87%
Immergrun	$132 - $178	97%
Ohio Healthy	$142	104%
Phphi	$142 - $158	104%
Php	$158	116%
Gms	$166 - $184	122%
Medical Benefit Corp	$184	135%
Consociate Health	$197	145%
Multiplan	$213 - $237	157%
Frontpath	$237	174%
Managed Care Services	$237	174%
Tertiary Care Network	$237	174%

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 $171.
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 Mercy Medical Center 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.