CMS Price Transparency Data

Psychological testing by technician

Facility: St Clair Hospital

Billing Code: 96138 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$121

about 0.3× the $456 Medicare rate · typically $46–$494

modeled estimate · not a bill or quote

What this hospital charges insurers

$974

Well above the fair price

about $853 over the fair price · 2.1× Medicare

Medicare pays $456 Fair price $121 This hospital $974 Cash price $297 Hospital's list price $1,198

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $60 Priciest $974

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a Psychological testing by technician is about $121 (about 0.3× the $456 Medicare rate). St Clair Hospital charges insurers about $974, or about $297 in cash — well above the fair price. Located in Pittsburgh, PA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $121. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$435 - $1,428	95%
Blue Cross Blue Shieldmajor	$388 - $974	85%
Aetnamajor	$448 - $1,166	98%
Cignamajor	$453 - $998	99%
Humanamajor	$435	95%
AmeriHealth	$435	95%
Geisinger	$448	98%
HealthPartners	$457	100%
UPMC Health Plan	$82 - $435	18%
+ 3 smaller / regional plans	$453 - $1,044

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 297), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 96138.

Insurance Before you use insurance

Call your insurance company to confirm St Clair Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 96138.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Clair Hospital

Compare: Psychological testing by technician at other PA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.