CMS Price Transparency Data

Psychological testing evaluation

Facility: Cook Childrens Medical Center Prosper

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $266
Cash Discount Price: $434
vs. Medicare Baseline: 1.96x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Cook Childrens Medical Center Prosper is $266. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $434. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 1.96x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$434

Average discount available for prompt cash payment at this facility.

Insurance Median

$266

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: $434 (319%)

Insurance Median: $266 (196%)

Cash: $434 (319% of Medicare)

Ins. Median: $266 (196% 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
Health Plan W. Uhrip	$15 - $20	11%
Health Plan W/O Uhrip	$15 - $313	11%
Aetna	$21 - $492	15%
Superior Health	$193	142%
Wellpoint	$202	149%
Blue Cross Blue Shield	$208 - $521	153%
United Community	$214 - $254	157%
UnitedHealthcare	$255 - $492	188%
Beacon	$266 - $313	196%
El Paso Health First	$266 - $313	196%
Tx Children Health	$266 - $313	196%
Firstcare	$280 - $463	206%
S&W Health	$487	358%
Cigna	$492	362%
Healthscope	$492	362%
Imagine Health	$492	362%
Humana	$504 - $510	371%
Multiplan	$504	371%
First Health	$510	375%
Galaxy Health	$521	383%
Healthsmart	$521	383%
Usamco	$533	392%

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 $434.
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 Cook Childrens Medical Center Prosper 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.