96137

Administration of psychological or neuropsychological test, each additional 30 minutes

Medicare pricing data for 4,411 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $18 in North Dakota to $48 in Alaska. Where you get this procedure matters more than almost any other factor. 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

Administration of psychological or neuropsychological test, each additional 30 minutes (HCPCS code 96137) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $36.51, but hospitals typically charge $119.81 — a 3.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.30

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $36.51, your out-of-pocket cost would be approximately $7.30. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$36.51
Average Hospital Charge
$119.81
Markup Ratio
3.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$119.81
Medicare Allowed$36.51
Medicare Payment$28.85

Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $28.85 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$48$2758410+30.3%
District of Columbia$44$12111763+19.8%
New Jersey$42$13812210,621+15.0%
Maryland$41$113797,074+13.6%
Hawaii$41$9913605+13.3%
New York$40$18922019,354+10.6%
Delaware$39$12581,097+6.6%
Puerto Rico$39$418508+6.1%
Oregon$38$115575,655+5.2%
Wyoming$38$887121+4.9%
Vermont$38$959498+4.9%
Connecticut$38$145775,858+4.4%
California$38$13043338,798+3.7%
Rhode Island$38$105383,214+3.3%
Florida$38$11528942,803+3.0%
Colorado$37$991198,410+2.5%
Pennsylvania$37$11319611,531+2.1%
Washington$37$113716,346+1.6%
Minnesota$37$1341233,280+1.3%
Arizona$37$126766,886+0.7%
Massachusetts$37$11116017,550+0.6%
Georgia$36$1321036,623-0.4%
Texas$36$10739335,610-0.6%
Utah$36$103361,751-0.9%
Idaho$36$99231,588-1.4%
Nebraska$36$107311,183-2.0%
Kansas$35$148282,165-3.4%
Nevada$35$89493,949-3.7%
Montana$35$9823633-3.7%
Mississippi$35$12325967-4.0%
Maine$35$11022841-4.4%
West Virginia$35$9118515-4.5%
Louisiana$35$7823617-5.0%
Indiana$35$93862,810-5.2%
Illinois$35$11823720,316-5.3%
North Carolina$34$1041546,791-5.6%
New Mexico$34$98361,420-6.1%
Alabama$34$84221,844-7.2%
New Hampshire$34$93263,642-7.4%
Kentucky$34$118443,570-7.8%
Tennessee$33$94778,260-8.4%
Arkansas$33$108303,667-8.4%
South Carolina$33$107475,752-9.2%
Ohio$33$991285,722-9.3%
Virginia$33$1371216,736-10.2%
Missouri$33$108683,045-10.6%
South Dakota$31$7925943-14.9%
Oklahoma$31$86392,573-15.1%
Iowa$30$115563,449-17.0%
Michigan$30$1361846,198-17.7%
Wisconsin$30$1491013,088-18.8%
North Dakota$18$4617565-49.8%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber