CMS Price Transparency Data

Psychological testing by technician

Facility: Childrens Hospital of Wisconsin

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $59
Cash Discount Price: $38
vs. Medicare Baseline: 0.13x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Childrens Hospital of Wisconsin is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.13x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.

Cash / Self-Pay

$38

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $38 (8%)

Insurance Median: $59 (13%)

Cash: $38 (8% of Medicare)

Ins. Median: $59 (13% 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
Froedtert Health	$48 - $59	11%
Medical College Of Wisconsin	$48	11%
Network Health Plan	$49	11%
UnitedHealthcare	$51 - $53	11%
Aspirus Health Plan	$52	11%
Common Ground Healthcare Cooperative	$52 - $59	11%
Trilogy Health Solutions	$52 - $59	11%
Advocate Aurora Healthcare	$53	12%
Wps Health Plan	$53 - $62	12%
Blue Cross Blue Shield	$54 - $66	12%
Centivo	$54	12%
Employer Health Care Alliance Cooperative	$54	12%
Health Partners	$54 - $61	12%
Dean Health Plan	$55	12%
Group Health Cooperative Of Eau Claire	$55	12%
Oan Llc	$55	12%
Security Health Plan	$57	12%
Health Payment Systems	$59	13%
Praire States	$59	13%
Quartz Health Insurance	$59	13%
Sheboygan Employer'S Health Network	$59	13%
Mayo Clinic Health Solutions	$60	13%
Aetna	$61 - $62	13%
Bellin Thedacare	$62	14%
Cigna	$62	14%
Group Health Cooperative Of South Central Wisconsin	$62	14%
Prevea Health Network	$62	14%
Multiplan	$63 - $66	14%
Coventry Health Care	$66	14%

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 $38.
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 Childrens Hospital of Wisconsin 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.