CMS Price Transparency Data

Psychological testing evaluation

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $130
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Independence Health System Butler Memorial Hospita is $130. 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 0.96x the Medicare baseline. Located in One Hospital Way, Butler, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$130

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: $130 (96%)

Ins. Median: $130 (96% 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
Medicaid / KanCare	$20	15%
UnitedHealthcare	$20 - $318	15%
Amerihealth	$22 - $130	16%
Geisinger	$22 - $130	16%
Jefferson Health Plan	$22	16%
Aetna	$23 - $285	17%
Gateway	$23 - $139	17%
Upmc	$23 - $175	17%
Behavioral	$35	26%
Pnoa	$58 - $136	43%
Workers Comp	$117	86%
Highmark	$122 - $262	90%
Life Butler County	$124	91%
Martin'S Point - Usfhp	$124	91%
Medicare (plans)	$124	91%
Peak Health	$124 - $291	91%
Provider Partners	$124	91%
Tricare	$124	91%
Humana	$129	95%
Devoted Health Plan	$131	96%
The Health Plan	$131 - $291	96%
Pa Health & Wellness	$133	98%
American Health Plan	$136	100%
Highmark Aca - Direct Blue	$163	120%
Ellwood Group	$248	182%
Highmark Community Blue	$256	188%
Cigna	$283	208%
Highmark - Ind.& Managed Care	$291	214%

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 $X.
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 Independence Health System Butler Memorial Hospita 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.