CMS Price Transparency Data

Psychological testing evaluation

Facility: Charleston Area Medical Center

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96136
Insurance Median: $91
Cash Discount Price: $152
vs. Medicare Baseline: 0.67x Medicare

The contracted insurance negotiated median rate for a Psychological testing evaluation at Charleston Area Medical Center is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.67x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$152

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $152 (112%)

Insurance Median: $91 (67%)

Cash: $152 (112% of Medicare)

Ins. Median: $91 (67% 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
Aetna	$18 - $166	13%
The Health Plan Of West Virginia Inc.	$18 - $164	13%
Unicare Health Plan Of West Virginia Inc.	$18 - $19	13%
Blue Cross Blue Shield	$27 - $154	20%
Choicecare Network	$27 - $166	20%
Triwest Va	$40 - $132	29%
Optimum Choice Inc.	$41 - $136	30%
UnitedHealthcare	$41 - $166	30%
West Virginia Senior Advantage Inc.	$43 - $143	32%
City Of Charleston	$53 - $127	39%
Tricare	$55 - $101	40%
Naphcare	$56 - $169	41%
Integrated Medical Solutions	$59 - $152	43%
Caresource	$61 - $169	45%
Three Rivers Providers Network	$88 - $164	65%
Healthsmart	$89 - $166	65%
Multiplan	$89 - $166	65%
Cigna	$90 - $157	66%

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 $152.
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 Charleston Area 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.