Evaluation of psychological test, first hour
Medicare pricing data for 4,005 providers across 51 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Evaluation of psychological test, first hour (HCPCS code 96130) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $114.75, but hospitals typically charge $267.57 — a 2.3x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $114.75, your out-of-pocket cost would be approximately $22.95. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.3x more than what Medicare allows for this procedure. Medicare actually pays $88.94 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $154 | $341 | 14 | 291 | +34.6% |
| New York | $127 | $222 | 127 | 3,387 | +10.8% |
| Washington | $124 | $357 | 67 | 3,768 | +8.0% |
| New Jersey | $121 | $230 | 62 | 1,723 | +5.6% |
| Rhode Island | $121 | $182 | 16 | 72 | +5.4% |
| Oregon | $120 | $213 | 44 | 826 | +4.4% |
| Hawaii | $120 | $276 | 10 | 66 | +4.2% |
| New Hampshire | $119 | $354 | 6 | 246 | +3.9% |
| Illinois | $119 | $374 | 141 | 1,514 | +3.5% |
| District of Columbia | $118 | $342 | 13 | 142 | +2.6% |
| California | $117 | $298 | 456 | 23,813 | +2.3% |
| Wyoming | $117 | $211 | 12 | 79 | +2.0% |
| Delaware | $117 | $437 | 8 | 236 | +1.7% |
| Maryland | $117 | $294 | 64 | 830 | +1.6% |
| Massachusetts | $116 | $196 | 61 | 1,118 | +1.4% |
| Montana | $115 | $247 | 14 | 98 | +0.5% |
| Florida | $115 | $277 | 279 | 11,374 | +0.5% |
| Nevada | $115 | $294 | 52 | 1,496 | +0.5% |
| Texas | $115 | $255 | 443 | 12,276 | +0.1% |
| Connecticut | $115 | $210 | 42 | 810 | -0.2% |
| North Carolina | $114 | $290 | 148 | 1,810 | -0.6% |
| New Mexico | $114 | $226 | 32 | 239 | -0.6% |
| Michigan | $114 | $291 | 211 | 2,857 | -0.8% |
| Idaho | $113 | $191 | 12 | 108 | -1.2% |
| Minnesota | $113 | $224 | 139 | 684 | -1.4% |
| Georgia | $113 | $245 | 105 | 2,057 | -1.4% |
| Nebraska | $113 | $268 | 34 | 264 | -1.9% |
| Kentucky | $113 | $209 | 35 | 660 | -2.0% |
| Maine | $113 | $202 | 23 | 121 | -2.0% |
| West Virginia | $112 | $180 | 26 | 187 | -2.0% |
| Oklahoma | $112 | $192 | 45 | 1,287 | -2.1% |
| Missouri | $112 | $238 | 80 | 880 | -2.2% |
| Colorado | $112 | $207 | 53 | 771 | -2.4% |
| South Dakota | $112 | $247 | 23 | 216 | -2.4% |
| South Carolina | $112 | $333 | 49 | 778 | -2.6% |
| Alabama | $112 | $184 | 60 | 2,072 | -2.6% |
| Louisiana | $112 | $242 | 38 | 411 | -2.7% |
| Wisconsin | $112 | $407 | 78 | 499 | -2.8% |
| Vermont | $111 | $249 | 4 | 17 | -2.9% |
| Iowa | $110 | $298 | 56 | 589 | -3.7% |
| Arizona | $110 | $268 | 90 | 2,191 | -3.9% |
| Indiana | $110 | $228 | 73 | 925 | -3.9% |
| Pennsylvania | $110 | $276 | 106 | 1,709 | -4.2% |
| Mississippi | $110 | $214 | 37 | 303 | -4.3% |
| Kansas | $110 | $261 | 39 | 895 | -4.3% |
| North Dakota | $109 | $257 | 34 | 165 | -4.7% |
| Ohio | $108 | $199 | 119 | 1,679 | -6.0% |
| Arkansas | $108 | $280 | 25 | 740 | -6.3% |
| Virginia | $107 | $202 | 126 | 2,558 | -7.1% |
| Utah | $104 | $224 | 44 | 611 | -9.3% |
| Tennessee | $102 | $222 | 98 | 6,615 | -10.7% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber