CMS Price Transparency Data

Psychological testing by technician

Facility: Nationwide Children's Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $122
Cash Discount Price: $147
vs. Medicare Baseline: 0.27x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Nationwide Children's Hospital is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $147. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.27x the Medicare baseline. Located in 700 Children's Drive, Columbus, OH.

Cash / Self-Pay

$147

Average discount available for prompt cash payment at this facility.

Insurance Median

$122

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%)

Cash / Self-Pay: $147 (32%)

Insurance Median: $122 (27%)

Cash: $147 (32% of Medicare)

Ins. Median: $122 (27% 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.

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
Tricare	$29	6%
Aetna	$37 - $173	8%
Caresource	$52 - $278	11%
UnitedHealthcare	$74 - $278	16%
Humana	$77 - $278	17%
Ohio Ppo Connect	$92 - $169	20%
Osu	$92 - $169	20%
Ohg	$103 - $164	23%
Blue Cross Blue Shield	$104 - $278	23%
Ohc	$106 - $169	23%
Ahpo	$107 - $171	23%
Cigna	$107 - $171	23%
Front Path Health Coalition	$107 - $171	23%
Mmo	$107 - $171	23%
Unicare	$108 - $173	24%
The Health Plan	$109 - $175	24%
Emerald Health	$112 - $178	25%
First Health	$112 - $178	25%
Phcs	$112 - $178	25%
Amerihealth	$278	61%
Bchp	$278	61%
Molina	$278	61%

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 $147.
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 Nationwide Children's Hospital 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.