CMS Price Transparency Data

Psychological testing by technician

Facility: Hospital of Univ of Pennsylvania

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96138
  • Insurance Median: $217
  • Cash Discount Price: $235
  • vs. Medicare Baseline: 0.48x Medicare
The contracted insurance negotiated median rate for a Psychological testing by technician at Hospital of Univ of Pennsylvania is $217. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $235. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.48x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$235

Average discount available for prompt cash payment at this facility.

Insurance Median
$217

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: $235 (51%)
Insurance Median: $217 (48%)
Cash: $235 (51% of Medicare)
Ins. Median: $217 (48% 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.

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 $23 - $235 5%
Ibc $26 - $479 6%
Horizon Nj Health $40 - $41 9%
Keystone Mercy Health Plan $47 - $235 10%
Preferred Health Care Eliance $52 11%
Aetna $53 - $498 12%
Pgm - Regie De L'Assurance Maladie Quebec $54 12%
Upmc $59 - $470 13%
Blue Cross Blue Shield $63 - $470 14%
Cigna $81 - $484 18%
Pgm - Kuwait Defense $82 - $106 18%
Qualcare $89 20%
Olympus $92 20%
Coventry $94 - $120 21%
Pgm - Chop $94 21%
Wissahickon Hospice $94 21%
Healthamerica/Coventry $106 - $115 23%
First Health Global $118 26%
Health Net $141 - $235 31%
Kaiser Permanente $141 - $470 31%
Pgm - Royal Embassy Of Saudi Arabia $141 31%
Paired Kidney Exchange $143 31%
Pgm - Embassy Of Qatar $153 34%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $153 34%
Interlink $157 34%
Pgm - Embassy Of The United Emirates/Ipc $164 36%
Health America/Ccn $188 41%
Humana $188 - $484 41%
Intergroup $188 41%
Pgm - Kuwait Health Division $188 41%
Pgm - Kuwait Oil $188 41%
Preferred Care $188 41%
UnitedHealthcare $188 - $999 41%
Ibc Commercial Hpn $211 46%
Keystone Hmo Proactive $217 48%
Blue Quality Centers For Transplant (Bqct) $235 51%
City Of Philadelphia Behavioral Health $235 51%
Commercial Other $235 51%
Gspp And Wissahickon Hospice $235 51%
Health Partners $235 - $484 51%
International Pfs $235 51%
Pa Medical Assistance $235 51%
United Behavioral Health $235 51%
Workers Compensation $235 51%
Tricare $430 94%
Medicare (plans) $470 - $479 103%
Philadelphia Va Medical Center $470 103%
Geisinger Health Plan $484 - $1,489 106%
Devoted Health $493 108%
Pa Health And Wellness $493 - $775 108%
Penn Life (Living Independently For Elders) $493 108%
Us Family Health Plan $495 108%
Clover Health Plan $507 111%
Keystone First $521 114%
Gateway Health Plan $582 128%
Elap $667 146%
Claims Watcher $751 - $845 165%
Oscar Health Plan $798 175%
Centivo $845 185%
Elap Services $873 191%
Highmark $987 216%
Penn Global Medicine $1,244 273%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals