CMS Price Transparency Data

Psychological testing evaluation

Facility: Allegheny General Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $40
Cash Discount Price: $16
vs. Medicare Baseline: 0.29x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Allegheny General Hospital is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.29x the Medicare baseline. Located in 320 East North Avenue, Pittsburgh, PA.

Cash / Self-Pay

$16

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

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: $16 (12%)

Insurance Median: $40 (29%)

Cash: $16 (12% of Medicare)

Ins. Median: $40 (29% 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
Univera	$19 - $28	14%
Amerihealth	$21 - $130	15%
Highmark	$21 - $309	15%
Life Pittsburgh	$22 - $124	16%
Medicare (plans)	$23 - $131	17%
Aetna	$24 - $414	18%
American Health Plans	$24 - $124	18%
Pennsylvania Health And Wellness	$26 - $30	19%
Highmark Wholecare	$28 - $131	21%
Geisinger	$29 - $32	21%
UnitedHealthcare	$29 - $432	21%
Cigna	$37 - $411	27%
Carelon	$40	29%
Community Care Behavorial Health Healthchoices	$60	44%
Community Care Behavorial Health University Of Pittsburgh Medical Center	$60	44%
Martin'S Point	$124	91%
Humana	$131	96%
Molina	$135	99%
Medical Mutual	$411	302%

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 $16.
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 Allegheny General 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.