CMS Price Transparency Data

Psychological testing evaluation

Facility: Cleveland Clinic Avon Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $132
  • Cash Discount Price: $171
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Cleveland Clinic Avon Hospital is $132. 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 0.97x the Medicare baseline. Located in 33300 Cleveland Clinic Blvd, Avon, OH.
Cash / Self-Pay
$171

Average discount available for prompt cash payment at this facility.

Insurance Median
$132

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: $132 (97%)
Cash: $171 (126% of Medicare)
Ins. Median: $132 (97% 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.

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
Oscar $79 - $101 58%
Summacare $97 - $120 71%
Cc Ehp $105 - $107 77%
Aultcare $113 83%
Amish Community Aid Plan $118 - $132 87%
Aetna $120 - $263 88%
Blue Cross Blue Shield $120 - $210 88%
Devoted Health $120 88%
Humana $120 88%
Mmo $120 - $141 88%
The Health Plan $120 - $158 88%
United $120 - $161 88%
UnitedHealthcare $120 - $163 88%
Upmc $120 - $158 88%
Valor $120 88%
Cigna $123 - $137 90%
Communicare $125 92%
Ohcp $128 94%
Perennial Health $129 95%
Pphp $131 96%
Zing Health $131 96%
Omas $132 97%
Ohio Healthy $142 104%
Buckeye $153 113%
Molina $153 113%
Caresource $156 115%
Php $158 116%
Gms $184 135%
Medical Benefit Corp $184 135%
Consociate Health $197 145%
Frontpath $237 174%
Managed Care Services $237 174%
Multiplan $237 174%
Tertiary Care Network $237 174%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 33300 Cleveland Clinic Blvd, Avon, OH 44011
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals