CMS Price Transparency Data

Psychological testing evaluation

Facility: Cannon Memorial Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $23
Cash Discount Price: $35
vs. Medicare Baseline: 0.17x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Cannon Memorial Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.17x the Medicare baseline. Located in 123 W G Acker Drive, Pickens, SC.

Cash / Self-Pay

$35

Average discount available for prompt cash payment at this facility.

Insurance Median

$23

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: $35 (26%)

Insurance Median: $23 (17%)

Cash: $35 (26% of Medicare)

Ins. Median: $23 (17% 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
Absolute Total Care [58]	$16	12%
Humana	$16 - $22	12%
Medicaid / KanCare	$16	12%
Select Health Of Sc [637]	$18	13%
Absolute Total Care Mcr Plans Alt Payer [4101]	$22	16%
Absolute Total Care Mcr Plans [41]	$22	16%
Aetna	$22 - $35	16%
Blue Choice Health Plan [922]	$22 - $59	16%
Blue Cross Blue Shield	$22 - $53	16%
Champva [604]	$22	16%
Cigna	$22 - $38	16%
Devoted Health Alt Payer [9401]	$22	16%
Devoted Health [94]	$22	16%
Medicare (plans)	$22 - $25	16%
Molina Dual Options Alt Payer [1501]	$22	16%
Molina Dual Options [15]	$22	16%
Tricare	$22	16%
UnitedHealthcare	$22 - $37	16%
Vaccn - Va Community Care Network [16]	$22	16%
Veterans Administration [633]	$22	16%
First Choice Vip Careplus Alt Payer [3301]	$23	17%
First Choice Vip [33]	$23	17%
Nhc Advantage Alt Payer [6101]	$23	17%
Nhc Advantage [61]	$23	17%
Bright Health Alt Payer [1001]	$25	18%
Ambetter / Centene	$31	23%
First Choice Next [96]	$31	23%
Molina Marketplace [97]	$31	23%
Bright Health [11]	$32	24%
Employee Benefit Management Services [869]	$34	25%
Mail Handlers Benefit Plan [327]	$35	26%
Rural Carrier Benefit Plan [406]	$35	26%
Workers Compensation [622]	$35	26%
Geha [302]	$37	27%
Golden Rule Ins Co [584]	$37	27%
Edison Health Solutions [95]	$38	28%
Healthscope [98]	$38	28%
Nalc Health Benefit Plan [291]	$38	28%
Planned Administrators [886]	$42	31%
Preferred Administrators [19]	$42	31%
Thomas Cooper & Company [315]	$42	31%
Medcost [206]	$43	32%
Phcs [940]	$62	46%

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 $35.
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 Cannon Memorial 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.