CMS Price Transparency Data

Psychological testing by technician

Facility: Legacy Good Samaritan Medical Center

Billing Code: 96138 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$547
about 1.2× the $456 Medicare rate · typically $131–$562
modeled estimate · not a bill or quote
Medicare pays $456 Fair price $547 Cash price $78 Hospital's list price $121

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Aetna✓ Kaiser Permanente UnitedHealthcareCignaHumana

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
Blue Cross Blue Shieldmajor $65 - $95 14%
Aetnamajor $521 114%
Kaiser Permanentemajor $497 - $993 109%
Health Net $526 115%
Moda Health $556 - $1,920 122%
+ 3 smaller / regional plans $511 - $546

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: 1015 Nw 22Nd Avenue, W121, Portland, OR 97210
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals