CMS Price Transparency Data

Psychological testing by technician

Facility: Lee County Community Hospital

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96138
  • Insurance Median: $326
  • Cash Discount Price: $161
  • vs. Medicare Baseline: 0.71x Medicare
The contracted insurance negotiated median rate for a Psychological testing by technician at Lee County Community Hospital is $326. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $161. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.71x the Medicare baseline. Located in 127 Health Care Drive, Pennington Gap, VA.
Cash / Self-Pay
$161

Average discount available for prompt cash payment at this facility.

Insurance Median
$326

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: $161 (35%)
Insurance Median: $326 (71%)
Cash: $161 (35% of Medicare)
Ins. Median: $326 (71% 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.

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 $15 - $1,150 3%
Aetna $154 - $1,161 34%
Ambetter / Centene $154 34%
Amerigroup $154 - $698 34%
Managed Medicaire $154 34%
Medicare (plans) $154 34%
Mountain Empire Pace $154 34%
Sentara Health $154 - $180 34%
United Mine Workers Of America $154 34%
Humana $156 34%
Blue Cross Blue Shield $158 - $1,116 35%
Molina Healthcare $160 - $1,161 35%
Cigna $161 - $698 35%
Devoted Health Plan $161 35%
Nhc Advantage $161 35%
Seven Corners, Inc. $369 81%
First Health Coventry $698 153%
Medcost $698 153%
Optima Health $1,116 245%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 127 Health Care Drive, Pennington Gap, VA 24277
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals