Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
PR PSY OR NSY TST ADMIN BY TECH EA 30 MIN
Low
$1
Average
$94
Median
$41
High
$394
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
30 hospitals; the 90th percentile is 175.0× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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35 hospital rates
iThe hospitals that file a Medicaid rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 2 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 3 | Allina Health Systems River Falls, WI facility · fee schedule · outpatient | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 4 | Beth Israel Deaconess Medical Center Boston, MA fee schedule · outpatient | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 5 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 6 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $394 | $394 | — | — | — | $394 – $394 |
| 7 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · inpatient | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 8 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 9 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CARMEL CARMEL, IN per diem · both | 2 | $175 | $175 | $16 | 9% | — | $159 – $191 |
| 10 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH INDIANAPOLIS INDIANAPOLIS, IN per diem · both | 16 | $159 | $166 | $13 | 8% | — | $159 – $191 |
| 11 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MOORESVILLE MOORESVILLE, IN per diem · both | 2 | $175 | $175 | $16 | 9% | — | $159 – $191 |
| 12 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 13 | Geisinger Lewistown Hospital Lewistown, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 14 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 15 | Geisinger Wyoming Valley Wilkes-Barre, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 16 | Grossmont Hospital Corporation La Mesa, CA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 17 | Grossmont Hospital Corporation La Mesa, CA percent of total billed charges · inpatientfrom % of charges | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 18 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $394 | $394 | — | — | — | $394 – $394 |
| 19 | Lahey Hospital & Medical Center, Burlington Peabody, MA fee schedule · outpatient | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 20 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 21 | Mercy Health Services-Iowa Corp. Mason City, IA professional · fee schedule · both | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 22 | Montefiore Medical Center Bronx, NY fee schedule · outpatient | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 23 | Montefiore Mount Vernon Hospital Mount Vernon, NY fee schedule · outpatient | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 24 | NYU Langone New York, NY case rate · both | 15 | $164 | $164 | — | — | — | $164 – $164 |
| 25 | NYU Langone Mineola, NY case rate · both | 15 | $120 | $120 | — | — | — | $120 – $120 |
← Payers reporting CPT 96139 · Snapshot 20261111T120946Z-9134e7f7