CMS Price Transparency Data

Psychological testing evaluation

Facility: Clarion Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $126
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Clarion Hospital is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.93x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$126

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%)
Insurance Median: $126 (93%)
Ins. Median: $126 (93% 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
Medicaid / KanCare $20 15%
Amerihealth $22 - $124 16%
Jefferson Health Plan $22 16%
Geisinger $24 - $130 18%
Upmc $25 - $138 18%
Workers Comp $58 43%
Highmark $123 - $206 90%
Cigna $124 91%
Highmark Community Blue $124 91%
Martin'S Point - Usfhp $124 91%
Medicare (plans) $124 91%
Tricare $124 91%
UnitedHealthcare $124 91%
Aetna $128 - $285 94%
Devoted Health Plan $131 96%
The Health Plan $131 - $291 96%
Gateway $133 98%
Pa Health & Wellness $133 98%
American Health Plan $136 100%
Highmark - Ind.& Managed Care $278 205%
Peak Health $291 214%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals