CMS Price Transparency Data

Psychological testing by technician

Facility: Lonesome Pine Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $439
Cash Discount Price: $164
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Lonesome Pine Hospital is $439. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $164. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.96x the Medicare baseline. Located in 1990 Holton Avenue East, Big Stone Gap, VA.

Cash / Self-Pay

$164

Average discount available for prompt cash payment at this facility.

Insurance Median

$439

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: $164 (36%)

Insurance Median: $439 (96%)

Cash: $164 (36% of Medicare)

Ins. Median: $439 (96% 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
UnitedHealthcare	$9 - $805	2%
Sentara Health	$276 - $400	60%
Aetna	$400 - $813	88%
Amerigroup	$400	88%
Humana	$400	88%
Managed Medicaire	$400	88%
Medicare (plans)	$400	88%
United Mine Workers Of America	$400	88%
Blue Cross Blue Shield	$412 - $1,090	90%
Cigna	$420 - $506	92%
Devoted Health Plan	$420	92%
Molina Healthcare	$420 - $820	92%
Mountain Empire Pace	$420	92%
Nhc Advantage	$420	92%
Wellcare	$424	93%
Medcost	$519	114%
Optima Health	$805	176%
Ambetter / Centene	$871	191%
Seven Corners, Inc.	$959	210%
First Health Coventry	$981	215%

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 $164.
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 Lonesome Pine Hospital 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.