CMS Price Transparency Data

Psychological testing evaluation

Facility: Samaritan North Lincoln Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $52
Cash Discount Price: $94
vs. Medicare Baseline: 0.38x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Samaritan North Lincoln Hospital is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.38x the Medicare baseline. Located in 3043 Ne 28Th Street, Lincoln City, OR.

Cash / Self-Pay

$94

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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: $94 (69%)

Insurance Median: $52 (38%)

Cash: $94 (69% of Medicare)

Ins. Median: $52 (38% 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.

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
Providence	$11 - $136	8%
Samaritan	$11 - $119	8%
Devoted Health	$12 - $58	9%
Pacificsource	$12 - $99	9%
Regence	$12 - $132	9%
Healthnet	$22 - $136	16%
Humana	$22 - $136	16%
Cigna	$23 - $136	17%
Moda	$27 - $133	20%
Aetna	$28 - $133	21%
Ihn	$44 - $58	32%
First Choice	$52 - $95	38%

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 $94.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96136.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Samaritan North Lincoln Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96136.
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.