CMS Price Transparency Data

Psychological testing evaluation

Facility: Punxsutawney Area Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $51
Cash Discount Price: $56
vs. Medicare Baseline: 0.38x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Punxsutawney Area Hospital is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.38x the Medicare baseline. Located in 81 Hillcrest Drive, Punxsutawney, PA.

Cash / Self-Pay

$56

Average discount available for prompt cash payment at this facility.

Insurance Median

$51

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: $56 (41%)

Insurance Median: $51 (38%)

Cash: $56 (41% of Medicare)

Ins. Median: $51 (38% 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
Highmark	$19 - $326	14%
Amerihealth Caritas	$22 - $137	16%
Highmark Wholecare	$22 - $129	16%
UnitedHealthcare	$22 - $139	16%
Upmc Health Plan	$23 - $146	17%
Geisinger Health Plan	$26 - $139	19%
Ambetter / Centene	$27 - $146	20%
Tricare	$35 - $102	26%
Aetna	$41 - $305	30%
United Mine Workers Of America	$42 - $139	31%
Pa Health And Wellness Commercial	$52 - $278	38%
Geisinger	$58 - $389	43%
Cigna	$86	63%
Humana	$137	101%
Pa Workers Compensation	$145	107%

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 $56.
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 Punxsutawney Area Hospital 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.