CMS Price Transparency Data

Psychological testing by technician

Facility: Cannon Memorial Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $32
Cash Discount Price: $50
vs. Medicare Baseline: 0.07x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Cannon Memorial Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.07x the Medicare baseline. Located in 123 W G Acker Drive, Pickens, SC.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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: $50 (11%)

Insurance Median: $32 (7%)

Cash: $50 (11% of Medicare)

Ins. Median: $32 (7% 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
Blue Choice Health Plan [922]	$19 - $31	4%
Blue Cross Blue Shield	$19 - $50	4%
Planned Administrators [886]	$19	4%
Thomas Cooper & Company [315]	$19	4%
Absolute Total Care [58]	$22	5%
Medicaid / KanCare	$22 - $23	5%
Humana	$23 - $31	5%
Select Health Of Sc [637]	$25	5%
Aetna	$31 - $49	7%
Champva [604]	$31	7%
Devoted Health Alt Payer [9401]	$31	7%
Devoted Health [94]	$31	7%
Medicare (plans)	$31 - $36	7%
Tricare	$31	7%
UnitedHealthcare	$31 - $52	7%
Vaccn - Va Community Care Network [16]	$31	7%
Veterans Administration [633]	$31	7%
Absolute Total Care Mcr Plans Alt Payer [4101]	$32	7%
Absolute Total Care Mcr Plans [41]	$32	7%
Cigna	$32 - $56	7%
First Choice Vip Careplus Alt Payer [3301]	$32	7%
First Choice Vip [33]	$32	7%
Molina Dual Options Alt Payer [1501]	$32	7%
Molina Dual Options [15]	$32	7%
Nhc Advantage Alt Payer [6101]	$32	7%
Nhc Advantage [61]	$32	7%
Bright Health Alt Payer [1001]	$36	8%
Ambetter / Centene	$44	10%
First Choice Next [96]	$44	10%
Molina Marketplace [97]	$44	10%
Bright Health [11]	$46	10%
Employee Benefit Management Services [869]	$48	11%
Workers Compensation [622]	$48	11%
Mail Handlers Benefit Plan [327]	$49	11%
Rural Carrier Benefit Plan [406]	$49	11%
Geha [302]	$52	11%
Golden Rule Ins Co [584]	$52	11%
Edison Health Solutions [95]	$54	12%
Healthscope [98]	$54	12%
Nalc Health Benefit Plan [291]	$56	12%
Preferred Administrators [19]	$60	13%
Medcost [206]	$62	14%
Phcs [940]	$88	19%

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 $50.
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 Cannon Memorial Hospital 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.