CMS Price Transparency Data

Psychological testing evaluation

Facility: Baylor Scott & White Medical Center - Marble Falls

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $185
Cash Discount Price: $216
vs. Medicare Baseline: 1.36x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Baylor Scott & White Medical Center - Marble Falls is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 1.36x the Medicare baseline. Located in 810 W Highway 71, Marble Falls, TX.

Cash / Self-Pay

$216

Average discount available for prompt cash payment at this facility.

Insurance Median

$185

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: $216 (159%)

Insurance Median: $185 (136%)

Cash: $216 (159% of Medicare)

Ins. Median: $185 (136% 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
Blue Cross Blue Shield	$65 - $118	48%
Superior Health Plan	$65 - $113	48%
Baylor Scott & White Health Plan	$107 - $186	79%
Humana	$113 - $252	83%
Triwest	$113	83%
American Health Plan	$118	87%
Corvel	$118	87%
Healthspring	$118	87%
Prime Health Services	$118	87%
Procare Advantage	$118	87%
UnitedHealthcare	$130 - $199	96%
Sedgwick	$168	124%
Cigna	$185 - $217	136%
Aetna	$198	146%
Midcoast	$198	146%
Quiktrip	$198	146%
University Of Mary Hardin-Baylor	$209	154%
Independent Medical System	$216	159%
Curative	$234	172%
First Health	$252	185%
Healthsmart	$252 - $270	185%
Bluebell Creameries	$270	199%
Private Health Care System	$270	199%
Three Rivers	$324	238%

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 $216.
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 Baylor Scott & White Medical Center - Marble Falls 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.