CMS Price Transparency Data

Psychological testing evaluation

Facility: Fairfield Medical Center

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $6,089
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 44.80x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Fairfield Medical Center is $6,089. 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 $135.93, this hospital’s rate is 44.80x 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
$6,089

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%)
Insurance Median: $6,089 (4480%)
Ins. Median: $6,089 (4480% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 4480% of the Medicare baseline (a markup of 4380%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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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 $191 141%
Molina $191 - $10,050 141%
UnitedHealthcare $191 - $6,091 141%
Caresource $193 - $7,918 142%
Blue Cross Blue Shield $197 - $26,250 145%
Humana $199 - $5,970 146%
Amerihealth Caritas Ohio $201 148%
Buckeye Community Health $201 - $9,441 148%
Aetna $5,970 4392%
Medical Mutual $5,970 - $33,500 4392%
Medicare (plans) $5,970 4392%
The Health Plan $6,089 4480%
Valor Health Plan $6,089 4480%
Medigold $6,091 4481%
Va Ccn $6,091 4481%
Oscar $6,200 4561%
Bwc $8,460 6224%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 401 North Ewing Street, Lancaster, OH 43130
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals