CMS Price Transparency Data

Psychological testing evaluation

Facility: Erlanger Medical Center

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $51
Cash Discount Price: $49
vs. Medicare Baseline: 0.38x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Erlanger Medical Center is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.38x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.

Cash / Self-Pay

$49

Average discount available for prompt cash payment at this facility.

Insurance Median

$51

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: $49 (36%)

Insurance Median: $51 (38%)

Cash: $49 (36% of Medicare)

Ins. Median: $51 (38% 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
UnitedHealthcare	$16 - $125	12%
Amerigroup	$30 - $69	22%
Aetna	$33 - $122	24%
Alexian	$33 - $118	24%
Blue Cross Blue Shield	$33 - $118	24%
Bluecard - Network S	$33 - $68	24%
Bluecare	$33 - $123	24%
Clover	$33 - $118	24%
Humana	$33 - $118	24%
Medicare (plans)	$33	24%
Upmc	$33 - $118	24%
American Health	$34 - $122	25%
Bluecard - Network P	$34 - $68	25%
Cigna	$34 - $224	25%
Devoted Health	$34 - $123	25%
Nhc	$34 - $124	25%
Pruitthealth Premier	$34	25%
Atrio Health	$36 - $130	26%
Simpra Advantage	$36	26%
Ambetter / Centene	$41 - $148	30%
Caresource	$41 - $236	30%
Peach State Hlth Plan	$41	30%
Caresource Ga	$46 - $82	34%
Caresource Tn	$46 - $82	34%
Olympus	$49 - $56	36%
Alliant	$53	39%
Caresource Nc	$55 - $82	40%
Occunet	$57 - $112	42%
Pnoa	$57 - $296	42%
Point Comfort Underwriters	$58 - $59	43%

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 $49.
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 Erlanger Medical Center 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.