CMS Price Transparency Data

Psychological testing by technician

Facility: Erlanger Medical Center

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $52
Cash Discount Price: $47
vs. Medicare Baseline: 0.11x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Erlanger Medical Center is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.11x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.

Cash / Self-Pay

$47

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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: $47 (10%)

Insurance Median: $52 (11%)

Cash: $47 (10% of Medicare)

Ins. Median: $52 (11% 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
UnitedHealthcare	$16 - $384	4%
Bluecare	$31 - $381	7%
Amerigroup	$33 - $98	7%
Blue Cross Blue Shield	$33 - $366	7%
Caresource	$33 - $732	7%
Peach State Hlth Plan	$33	7%
Cigna	$34 - $699	7%
Aetna	$41 - $377	9%
Humana	$41 - $366	9%
Alexian	$48 - $366	11%
Clover	$48 - $366	11%
Medicare (plans)	$48	11%
Upmc	$48 - $366	11%
American Health	$49 - $377	11%
Pruitthealth Premier	$49	11%
Devoted Health	$50 - $381	11%
Nhc	$50 - $384	11%
Atrio Health	$53 - $403	12%
Simpra Advantage	$53	12%
Ambetter / Centene	$60 - $458	13%
Caresource Ga	$70 - $125	15%
Caresource Tn	$70 - $125	15%
Olympus	$72 - $82	16%
Pnoa	$75 - $915	16%
Alliant	$77	17%
Caresource Nc	$84 - $125	18%
Occunet	$84 - $348	18%
Point Comfort Underwriters	$84 - $86	18%

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 $47.
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 Erlanger Medical Center 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.