Psychological testing evaluation
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 96136 (CPT)
- CPT Billing Code: 96136
- Insurance Median: $119
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.88x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $41 - $334 | 30% |
| Aetna | $43 | 32% |
| Medicaid / KanCare | $43 - $54 | 32% |
| Providrs Care | $54 | 40% |
| Medicare (plans) | $119 - $122 | 88% |
| Humana | $119 - $120 | 88% |
| Va | $119 | 88% |
| Smarthealth | $167 | 123% |
| Ambetter / Centene | $203 | 149% |
Consumer Guidance & Cost Commentary
For the CPT code 96136, Psychological testing evaluation, the negotiated rates at Ascension Via Christi Hospital Manhattan range from $41 to $203 depending on the insurance carrier. The median negotiated rate across all payers is $119.00, which is significantly lower than the Medicare benchmark of $135.93. While Medicare serves as the objective baseline for "true cost," commercial rates can vary widely; for instance, UnitedHealthcare plans see rates as low as $41, whereas Ambetter/Centene plans are set at $203. Patients with high-deductible plans should consider that cash-pay options might be more economical if the insurance negotiated rate exceeds the cash price, though cash rates are not listed for this specific service. It is always advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% when paid upfront.
When reviewing your bill, ensure you receive a detailed itemized statement rather than a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If you receive a balance bill for an out-of-network service at this in-network facility, you may be protected under the No Surprises Act, which bans balance billing for emergency and non-emergency services. To resolve any unexpected charges, do not pay immediately out of fear of credit damage; instead, request a formal itemized audit and dispute the bill in writing with the billing supervisor. By comparing the facility's rates to the Medicare benchmark and verifying your deductible status before scheduling, you can avoid common pitfalls like paying inflated negotiated rates or