CMS Price Transparency Data

Psychological testing by technician

Facility: Sycamore Shoals Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96138
  • Insurance Median: $400
  • Cash Discount Price: $164
  • vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Psychological testing by technician at Sycamore Shoals Hospital is $400. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $164. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.88x the Medicare baseline. Located in 1501 West Elk Avenue, Elizabethton, TN.
Cash / Self-Pay
$164

Average discount available for prompt cash payment at this facility.

Insurance Median
$400

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: $164 (36%)
Insurance Median: $400 (88%)
Cash: $164 (36% of Medicare)
Ins. Median: $400 (88% 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.

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
UnitedHealthcare $15 - $426 3%
Amerigroup $192 - $372 42%
Sentara Health $303 - $372 66%
Aetna $372 - $879 82%
Humana $372 82%
Managed Medicaire $372 82%
Medicare (plans) $372 82%
United Mine Workers Of America $372 82%
Medcost $382 84%
Blue Cross Blue Shield $383 - $846 84%
Molina Healthcare $386 - $879 85%
Cigna $390 - $519 85%
Devoted Health Plan $390 85%
Nhc Advantage $390 85%
Wellcare $394 - $1,090 86%
Ambetter / Centene $810 177%
First Health Coventry $818 179%
Optima Health $846 185%
Seven Corners, Inc. $1,090 239%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1501 West Elk Avenue, Elizabethton, TN 37643
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals