CMS Price Transparency Data

Psychological testing evaluation

Facility: Astria Sunnyside Hospital

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $163
Cash Discount Price: $307
vs. Medicare Baseline: 1.20x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Astria Sunnyside Hospital is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $307. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 1.20x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$307

Average discount available for prompt cash payment at this facility.

Insurance Median

$163

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: $307 (226%)

Insurance Median: $163 (120%)

Cash: $307 (226% of Medicare)

Ins. Median: $163 (120% 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
Medicare (plans)	$27 - $136	20%
Aetna	$132 - $474	97%
Healthcomp_Ihs	$132	97%
Humana	$132 - $485	97%
Medicaid / KanCare	$132 - $165	97%
Molina	$132	97%
Va	$132	97%
Tricare	$134	99%
Li	$331	244%
First_Choice	$404	297%
Tpsc	$420	309%
Kaiser	$423	311%
Premera	$439	323%
UnitedHealthcare	$458	337%
Fhpw	$474	349%
Healthcomp	$485	357%
Bcchp	$539	397%
Great_Rivers	$539	397%
Zenith	$539	397%

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 $307.
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 Astria Sunnyside 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.