CMS Price Transparency Data

Psychological testing evaluation

Facility: El Paso Children's Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $52
Cash Discount Price: $16
vs. Medicare Baseline: 0.38x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at El Paso Children's Hospital is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.38x the Medicare baseline. Located in 4845 Alameda Avenue, El Paso, TX.

Cash / Self-Pay

$16

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

$135.93

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.93 (100%)

Cash / Self-Pay: $16 (12%)

Insurance Median: $52 (38%)

Cash: $16 (12% of Medicare)

Ins. Median: $52 (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
El Paso Health Plans	$15	11%
Blue Cross Blue Shield	$17 - $62	13%
Uh Military Va	$20	15%
Health Net Fed Svcs	$22	16%
El Paso First Health Plan	$23	17%
Western Sky	$43	32%
Molina Nm	$45	33%
Aetna	$59 - $66	43%
UnitedHealthcare	$59	43%
Cigna	$64	47%
Coventry Health Care	$66	49%
Fortified Provider Network	$66	49%
Multiplan	$66	49%

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 $16.
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 El Paso Children's Hospital 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.