CMS Price Transparency Data

Psychological testing evaluation

Facility: Medical City Plano

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $35
Cash Discount Price: $77
vs. Medicare Baseline: 0.26x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Medical City Plano is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.26x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$35

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: $77 (57%)

Insurance Median: $35 (26%)

Cash: $77 (57% of Medicare)

Ins. Median: $35 (26% 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
Superior Health Plan	$5	4%
Cigna	$10 - $29	7%
Aetna	$13 - $47	10%
United	$13	10%
Oscar	$16	12%
Healthcare Highways	$19 - $26	14%
Evry Health	$20	15%
Lifecare Hospitals	$23	17%
Humana	$24	18%
Curative Administrators	$31	23%
Prominence Health Plan	$31	23%
Blue Cross Blue Shield	$34 - $123	25%
City Of Mckinney	$35	26%
Fidelis Securecare	$35	26%
National Choicecare	$39	29%
Pc Texas Partners	$43	32%
Physicians Coop Of Tx	$43	32%
Rockport Health Group	$43	32%
Averde Health, Inc	$45	33%
Texas Healthcare Foundation Wc	$50	37%
Coastal Comp Health Networks	$54	40%
Mega Life	$54	40%
Multiplan Phcs	$54	40%
Healthsmart Preferred Care	$58	43%
Lewisville Isd/Dls Consulting	$58	43%
Usa Managed Care	$62	46%
Usc Health Services	$62	46%
Galaxy Health Network	$66	49%
Independent Medical Systems	$77	57%
National Healthcare Solutions	$77	57%
Unicare	$77	57%

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 $77.
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 Medical City Plano 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.