CMS Price Transparency Data

Psychological testing evaluation

Facility: UPMC Passavant

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $129
Cash Discount Price: $184
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at UPMC Passavant is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $184. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.95x the Medicare baseline. Located in 9100 Babcock Boulevard, Pittsburgh, PA.

Cash / Self-Pay

$184

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $184 (135%)

Insurance Median: $129 (95%)

Cash: $184 (135% of Medicare)

Ins. Median: $129 (95% 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
Upmc Health Plan	$22 - $129	16%
UnitedHealthcare	$23 - $135	17%
Blue Cross Blue Shield	$28 - $199	21%
Highmark Wholecare (Prev Gateway)	$30 - $133	22%
Amerihealth Caritas	$31 - $133	23%
Pa Health & Wellness	$34 - $133	25%
Upmc Work Partners	$56	41%
Private Health Care Systems	$65 - $285	48%
Cigna	$104 - $122	77%
Health Plan Of Upper Ohio Valley	$123 - $141	90%
Aetna	$129 - $135	95%
Coventry/First Health	$214	157%
Intergroup	$254 - $275	187%
Humana	$260 - $285	191%
Multiplan	$260 - $285	191%

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 $184.
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 UPMC Passavant 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.