CMS Price Transparency Data

Psychological testing by technician

Facility: Cook Childrens Medical Center

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $163
Cash Discount Price: $284
vs. Medicare Baseline: 0.36x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Cook Childrens Medical Center is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $284. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.36x the Medicare baseline. Located in 801 Seventh Avenue, Fort Worth, TX.

Cash / Self-Pay

$284

Average discount available for prompt cash payment at this facility.

Insurance Median

$163

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: $284 (62%)

Insurance Median: $163 (36%)

Cash: $284 (62% of Medicare)

Ins. Median: $163 (36% 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
Beacon	$73 - $199	16%
Firstcare	$73 - $361	16%
Health Plan W/O Uhrip	$73 - $151	16%
Health Plan W. Uhrip	$102 - $172	22%
Rightcare	$102 - $199	22%
United Community	$107 - $159	23%
Wellpoint	$107 - $159	23%
Blue Cross Blue Shield	$110 - $407	24%
Molina	$113 - $167	25%
El Paso Health First	$135 - $199	30%
Superior Health	$135 - $199	30%
Tx Children Health	$135 - $199	30%
UnitedHealthcare	$135 - $384	30%
Aetna	$148 - $384	32%
S&W Health	$257 - $380	56%
Cigna	$260 - $384	57%
Healthscope	$260 - $384	57%
Imagine Health	$260 - $384	57%
Humana	$266 - $398	58%
Multiplan	$266 - $393	58%
First Health	$269 - $398	59%
Galaxy Health	$275 - $407	60%
Healthsmart	$275 - $407	60%
Usamco	$281 - $416	62%

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 $284.
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 Cook Childrens 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.