CMS Price Transparency Data

Psychological testing by technician

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $313
Cash Discount Price: $239
vs. Medicare Baseline: 0.69x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at University of Wi Hospitals & Clinics Authority is $313. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $239. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.69x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.

Cash / Self-Pay

$239

Average discount available for prompt cash payment at this facility.

Insurance Median

$313

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$456.4

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $456.4 (100%)

Cash / Self-Pay: $239 (52%)

Insurance Median: $313 (69%)

Cash: $239 (52% of Medicare)

Ins. Median: $313 (69% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $456.4 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
Blue Cross Blue Shield	$163 - $456	36%
Alliance_Premier_Network	$191	42%
Mercycare	$198	43%
Triology	$203 - $243	44%
Security_Health_Plan	$215 - $253	47%
Employer'S_Coalition_On_Health	$219 - $307	48%
Alliance	$224	49%
Hfn	$227 - $307	50%
United_Healthcare	$229 - $339	50%
Beloit_Health_System	$231	51%
Aspirus_Health_Plan	$233	51%
Cigna	$239	52%
Health_Partners_Insurance	$243	53%
Health_Payment_Systems	$245	54%
UnitedHealthcare	$250 - $456	55%
Dean_Health_Plan	$255	56%
Medical_Associates	$263	58%
Wps	$277 - $304	61%
Employers_Healthcare_Coalition_Of_Wi	$279	61%
Aetna	$284 - $456	62%
Aspirus_Network_Inc	$307	67%
Chorus_Community	$319	70%
Ghc_Eau_Claire_Health_Plan	$319	70%
Multiplan	$319 - $367	70%
Sheybogan_Employers_Health_Network	$319	70%
Coventry	$339	74%
Dean_Care	$339	74%
Healthsmart	$351	77%
Humana	$456	100%
Medicare (plans)	$456 - $466	100%

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 $239.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96138.

Insurance In-Network Protection Plan

Contact your insurance company to confirm University of Wi Hospitals & Clinics Authority is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96138.
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.