CMS Price Transparency Data

Psychological testing by technician

Facility: Fairfield Medical Center

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $6,124
Cash Discount Price: Unavailable
vs. Medicare Baseline: 13.42x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Fairfield Medical Center is $6,124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 13.42x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,124

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%)

Insurance Median: $6,124 (1342%)

Ins. Median: $6,124 (1342% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1342% of the Medicare baseline (a markup of 1242%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$191	42%
Molina	$191 - $10,105	42%
UnitedHealthcare	$191 - $6,124	42%
Caresource	$193 - $7,962	42%
Blue Cross Blue Shield	$197 - $26,250	43%
Humana	$199 - $6,003	44%
Amerihealth Caritas Ohio	$201	44%
Buckeye Community Health	$201 - $9,493	44%
Aetna	$6,003	1315%
Medical Mutual	$6,003 - $33,500	1315%
Medicare (plans)	$6,003	1315%
Medigold	$6,124	1342%
The Health Plan	$6,124	1342%
Va Ccn	$6,124	1342%
Valor Health Plan	$6,124	1342%
Oscar	$6,460	1415%
Bwc	$8,507	1864%

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 $X.
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 Fairfield Medical Center 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.