CMS Price Transparency Data

Psychological testing evaluation

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $53
Cash Discount Price: $61
vs. Medicare Baseline: 0.39x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.39x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$61

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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: $61 (45%)

Insurance Median: $53 (39%)

Cash: $61 (45% of Medicare)

Ins. Median: $53 (39% 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
The Alliance	$32	24%
Security Health Plan (Shp)	$33 - $37	24%
Amish/Mennonite	$35	26%
Quartz	$36	26%
Blue Cross Blue Shield	$40 - $47	29%
Wps Health Insurance	$43	32%
Cigna	$44 - $47	32%
Health Payment Systems	$45	33%
UnitedHealthcare	$48	35%
Humana	$51 - $57	38%
Group Health Cooperative Of Eau Claire	$52 - $61	38%
Network Health Plan	$53	39%
First Health	$54	40%
Molina Healthcare Of Wi	$54	40%
Trilogy	$58	43%
Healtheos By Multiplan Inc.	$60 - $61	44%
Coventry	$61	45%
Health Partners	$61	45%

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 $61.
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 Marshfield Medical Center - Beaver Dam (Mmc-Bd) 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.