Psychological testing evaluation
Facility: Lindsborg Community Hospital
Billing Code: 96136 (CPT)
- CPT Billing Code: 96136
- Insurance Median: $119
- Cash Discount Price: $91
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $38 | 28% |
| Tricare | $61 | 45% |
| Coventry Mcr Adv | $62 | 46% |
| Cigna | $110 | 81% |
| UnitedHealthcare | $117 | 86% |
| Coventry Comm-All Other Plans | $117 | 86% |
| Multiplan-All Plans | $121 | 89% |
| Phcs Preferred-All Plans | $121 | 89% |
| Coventry Wc | $124 | 91% |
| Health Partners -All Plans | $124 | 91% |
| Century Health-All Plans | $124 | 91% |
| Wppa-All Plans | $124 | 91% |
Consumer Guidance & Cost Commentary
For the CPT code 96136, Psychological testing evaluation, Lindsborg Community Hospital in Kansas reported a gross charge of $130.00. While the facility's cash median rate is $91.00, which is lower than the state average, the negotiated rates for in-network payers range from $38.00 to $124.00. Patients with high-deductible plans may find the cash price of $91.00 more affordable than the negotiated rates if their insurance allowed amounts exceed this figure. It is important to note that commercial negotiated rates often include administrative overhead and can be significantly higher than the cash price, so verifying your specific plan's allowed amount before scheduling is essential to avoid unexpected costs.
The Medicare benchmark for this service is $135.93, which serves as a reliable baseline for evaluating pricing fairness, as commercial rates are frequently marked up relative to this federal standard. Although the data does not provide specific county averages for comparison, the facility is a Critical Access Hospital in Lindsborg, KS, and offers a voluntary non-profit ownership structure. To minimize potential balance billing or errors, consumers should request a full itemized bill before paying, as summary invoices can obscure individual charges. Additionally, patients should inquire about prompt-pay discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, bypassing the higher administrative costs associated with insurance claims processing.