CMS Price Transparency Data

Psychological testing by technician

Facility: Penn State Health St. Joseph

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $518
Cash Discount Price: $675
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Penn State Health St. Joseph is $518. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $675. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 1.13x the Medicare baseline. Located in 2500 Bernville Road, Reading, PA.

Cash / Self-Pay

$675

Average discount available for prompt cash payment at this facility.

Insurance Median

$518

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: $675 (148%)

Insurance Median: $518 (113%)

Cash: $675 (148% of Medicare)

Ins. Median: $518 (113% 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
[Amerihealth Caritas]	$386 - $454	85%
[Highmark Wholecare]	$386 - $454	85%
[Geisinger]	$409 - $1,871	90%
[Health Partners Plans]	$423 - $463	93%
[Pa Health & Wellness]	$425 - $468	93%
[Highmark]	$450 - $2,469	99%
UnitedHealthcare	$454 - $1,756	99%
[Cbc]	$454 - $1,371	99%
[Ibc]	$454 - $1,289	99%
Aetna	$459 - $1,325	101%
Humana	$459	101%
[Healthspring]	$459	101%
[Upmc]	$463 - $1,916	101%
[Point Comfort Underwriters]	$568	124%
Cigna	$1,591	349%
[Preferred Healthcare Systems]	$1,946	426%
[Highmark Choice Blue]	$1,976	433%
[Highmark Aca]	$2,074	454%
[First Health]	$2,075	455%
[Multiplan]	$2,075	455%

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 $675.
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 Penn State Health St. Joseph 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.