Price Checker / CPT 96130
How much does Psycl Tst Evaluation Phys/qhp 1st cost?
CPT 96130 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is about 2.5x the fair price. You have grounds to ask for a reduction.
Fair price
$270–$310
What this should cost
With insurance
~$640
Typical out-of-pocket
Overcharged if over
$390
Push back above this
The average hospital charge of $714 is $424 over the fair price (about 2.5x the fair rate).
What hospitals charge for Psycl Tst Evaluation Phys/qhp 1st
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Voyages Behavioral Health of Conroe CONROE, TX | $1,377 | — | 1011% |
| Voyages of Sugar Land , TX | $1,377 | — | 1011% |
| UM Rehabilitation & Orthopaedic Institute Baltimore, MD | $1,097 | — | 785% |
| UPMC Western Psychiatric , PA | $830 | $664 | 570% |
| Gateways Hospital and Mental Health Center Los Angeles, CA | $532 | — | 329% |
| JD McCarty Center Norman, OK | $150 | — | 296% |
| Pine Rest Christian Mental Health Services GRAND RAPIDS, MI | $226 | $181 | 82% |
| Pathways Behavioral Health Services , TN | $125 | $125 | 1% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Psycl Tst Evaluation Phys/qhp 1st
CPT code 96130 refers to psycl tst evaluation phys/qhp 1st (billing description: "Psycl tst eval phys/qhp 1st"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $100 in a facility (hospital or surgery center) and $124 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.