CMS Price Transparency Data

Psychological testing evaluation

Facility: Childrens Hospital of Wisconsin

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $59
Cash Discount Price: $38
vs. Medicare Baseline: 0.43x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation 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 $135.93, this hospital’s rate is 0.43x 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

$135.93

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.93 (100%)

Cash / Self-Pay: $38 (28%)

Insurance Median: $59 (43%)

Cash: $38 (28% of Medicare)

Ins. Median: $59 (43% 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
Froedtert Health	$48 - $59	35%
Medical College Of Wisconsin	$48	35%
Network Health Plan	$49	36%
UnitedHealthcare	$51 - $53	38%
Aspirus Health Plan	$52	38%
Common Ground Healthcare Cooperative	$52 - $59	38%
Trilogy Health Solutions	$52 - $59	38%
Advocate Aurora Healthcare	$53	39%
Wps Health Plan	$53 - $62	39%
Blue Cross Blue Shield	$54 - $66	40%
Centivo	$54	40%
Employer Health Care Alliance Cooperative	$54	40%
Health Partners	$54 - $61	40%
Dean Health Plan	$55	40%
Group Health Cooperative Of Eau Claire	$55	40%
Oan Llc	$55	40%
Security Health Plan	$57	42%
Health Payment Systems	$59	43%
Praire States	$59	43%
Quartz Health Insurance	$59	43%
Sheboygan Employer'S Health Network	$59	43%
Mayo Clinic Health Solutions	$60	44%
Aetna	$61 - $62	45%
Bellin Thedacare	$62	46%
Cigna	$62	46%
Group Health Cooperative Of South Central Wisconsin	$62	46%
Prevea Health Network	$62	46%
Multiplan	$63 - $66	46%
Coventry Health Care	$66	49%

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: 96136.

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 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.