CMS Price Transparency Data

Psychological testing by technician

Facility: UPMC Horizon

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $101
Cash Discount Price: $124
vs. Medicare Baseline: 0.22x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at UPMC Horizon is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $124. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.22x the Medicare baseline. Located in 110 North Main Street, Greenville, PA.

Cash / Self-Pay

$124

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $124 (27%)

Insurance Median: $101 (22%)

Cash: $124 (27% of Medicare)

Ins. Median: $101 (22% 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
Upmc Work Partners	$44	10%
Blue Cross Blue Shield	$54 - $714	12%
UnitedHealthcare	$68 - $407	15%
Upmc Health Plan	$72 - $392	16%
Aetna	$76 - $399	17%
Cigna	$80 - $411	18%
Geisinger	$113	25%
Pa Health & Wellness	$113 - $411	25%
Intergroup	$134	29%
Coventry/First Health	$136	30%
Health Coalition Partners	$144	32%
Private Health Care Systems	$165	36%
Prime Net	$169	37%
Humana	$175	38%
Amerihealth Caritas	$411	90%
Highmark Wholecare (Prev Gateway)	$411	90%

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 $124.
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 UPMC Horizon 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.