CMS Price Transparency Data

Psychological testing evaluation

Facility: Astria Toppenish Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $203
  • Cash Discount Price: $200
  • vs. Medicare Baseline: 1.49x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Astria Toppenish Hospital is $203. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $200. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 1.49x the Medicare baseline. Located in 502 W Fourth Ave, Toppenish, WA.
Cash / Self-Pay
$200

Average discount available for prompt cash payment at this facility.

Insurance Median
$203

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: $200 (147%)
Insurance Median: $203 (149%)
Cash: $200 (147% of Medicare)
Ins. Median: $203 (149% 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.

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
Medicaid / KanCare $12 - $522 9%
Premera_Affordable_Care $29 - $203 21%
Chpw_Cascade_Care $48 - $340 35%
First_Choice $52 - $372 38%
Tpsc $59 - $420 43%
Medicare (plans) $63 - $537 46%
UnitedHealthcare $63 - $522 46%
Aetna $67 - $474 49%
Bcchp $76 - $539 56%
Great_Rivers $76 - $539 56%
Healthcomp $76 - $539 56%
Humana $76 - $539 56%
Washington_State_Hca $76 - $539 56%
Li $119 88%
Cigna $130 96%
Tricare $130 96%
Zenith $132 97%
Kaiser $455 335%
Ambetter / Centene $522 384%
Va $522 - $682 384%
Molina $532 391%
Molina_Exchange $678 499%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 502 W Fourth Ave, Toppenish, WA 98948
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals