CMS Price Transparency Data

Psychological testing by technician

Facility: SSM Health St Agnes Hospital-Fond Du Lac

Billing Code: 96138 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$366

about 0.8× the $456 Medicare rate · typically $84–$655

modeled estimate · not a bill or quote

Medicare pays $456 Fair price $366 Cash price $92 Hospital's list price $168

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

1 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield UnitedHealthcareAetnaCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
Blue Cross Blue Shieldmajor	$442	97%
Molina	$331	73%
WellCare	$451	99%
+ 1 smaller / regional plan	$853

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 92), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 96138.

Insurance Before you use insurance

Call your insurance company to confirm SSM Health St Agnes Hospital-Fond Du Lac is in-network.
Ask your insurer whether prior approval is required for CPT code 96138.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at SSM Health St Agnes Hospital-Fond Du Lac

Compare: Psychological testing by technician at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.