CMS Price Transparency Data

Psychological testing evaluation

Facility: Gundersen Lutheran Medical Center

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $27
Cash Discount Price: $12
vs. Medicare Baseline: 0.20x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Gundersen Lutheran Medical Center is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.20x the Medicare baseline. Located in 1910 South Ave, La Crosse, WI.

Cash / Self-Pay

$12

Average discount available for prompt cash payment at this facility.

Insurance Median

$27

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: $12 (9%)

Insurance Median: $27 (20%)

Cash: $12 (9% of Medicare)

Ins. Median: $27 (20% 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
Medica	$11 - $25	8%
Dean Health Plan	$13	10%
Ucare	$13 - $134	10%
Aetna	$14 - $128	10%
Quartz	$14	10%
Health Partners	$16 - $122	12%
Medical Associates	$22 - $128	16%
Midland Choice	$24	18%
Alliance	$25 - $27	18%
Blue Cross Blue Shield	$25 - $264	18%
Cigna	$26	19%
Claim Doc Llc	$26	19%
Group Health Of South Central	$26 - $264	19%
UnitedHealthcare	$26 - $264	19%
Wps - Arise	$26	19%
Wps Narrow Network	$26	19%
Allied National General	$27	20%
Aspirus Arise Health	$27	20%
Preferred One	$27	20%
Wps Statewide	$27	20%
Group Health Eau Claire	$29 - $264	21%
Coventry Health Care	$30	22%
Humana	$30	22%
Multiplan/Healtheos	$31	23%
Amerigroup	$122 - $264	90%
Molina Health	$122 - $264	90%
Icare	$128 - $264	94%
Iowa Total Care	$264	194%
Managed Health Service	$264	194%

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 $12.
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 Gundersen Lutheran Medical Center 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.