CMS Price Transparency Data

Psychological testing evaluation

Facility: Dekalb Community Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $122
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Dekalb Community Hospital is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.90x the Medicare baseline. Located in 520 W Main St, Smithville, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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%)
Insurance Median: $122 (90%)
Ins. Median: $122 (90% 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.

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
Aetna $24 - $124 18%
Point Comfort Underwriters $110 81%
Amerigroup Mcr Replacement $122 90%
Ascension Complete $122 90%
Blue Cross Blue Shield $122 - $128 90%
Centurion Of Tn $122 90%
Covid Uninsured Test Fund $122 90%
Healthspring Mcr Replacement $122 90%
Humana $122 90%
Medicare (plans) $122 90%
Nhc Advantage $122 90%
UnitedHealthcare $122 90%
Ambetter / Centene $158 116%
Oscar Health $170 125%
Smart Health $170 125%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 520 W Main St, Smithville, TN 37166
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals