CMS Price Transparency Data

Psychological testing evaluation

Facility: Forks Community Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $23
Cash Discount Price: $24
vs. Medicare Baseline: 0.17x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Forks Community Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.17x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$24

Average discount available for prompt cash payment at this facility.

Insurance Median

$23

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: $24 (18%)

Insurance Median: $23 (17%)

Cash: $24 (18% of Medicare)

Ins. Median: $23 (17% 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
Coordinated Care (Mco) Mcd-All Plans	$13	10%
Medicaid / KanCare	$13 - $14	10%
UnitedHealthcare	$13 - $30	10%
Humana	$22	16%
Molina Commercial-All Other Plans	$22	16%
Tricare	$22	16%
Triwest-All Plans	$22	16%
Va-Ihs - All Plans	$22	16%
Cigna	$24	18%
Ambetter / Centene	$25	18%
Community Health Network Mcr-All Other Plans	$25	18%
Medicare (plans)	$25	18%
Wellcare Med Adv - All Plans	$25	18%
Aetna	$29	21%
Community Health Exchange	$29	21%
Regence-All Other Plans	$31	23%
Blue Cross Blue Shield	$33	24%
First Choice-All Plans	$33	24%

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 $24.
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 Forks Community Hospital 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.