Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 84138 Fee Schedule
Medicare rates as of January 2026
CPT 84138 is classified under Pathology and Laboratory Procedures, in the Chemistry Procedures subgroup.
Hormone Metabolism Test, This Test Is Commonly Referred To As The 17-Oh-Progesterone Test. The Hormone Affects Adrenal Gland Hormone Secretion.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Complexity Level | Low |
| Medicare Fee Schedule | $21.05 national lab fee schedule rate (2026) · View Medicare rates for 84138 |
| Medicaid Fee Schedule | $20.785 median of the 8 states in the free preview · View Medicaid rates for 84138 |
National average reimbursement for CPT 84138 by major payers:
$17.97
BCBS / Anthem
$14.37
UnitedHealthcare
$21.49
Aetna
$30.54
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 84138.
CPT 84138
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$46.31Published rateChristopher Raio
Mercy Medical Center
$25.94Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$21.05Published ratePrisma Health-Upstate, Prisma Health Op Surgery Spartanburg
Prisma Health - Upstate
$18.95Published rateDana Hemstreet
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$8.84Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 84138 vs. Other Chemistry Procedures Codes
The table lists codes related to 84138. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 84135-CPT | Low | Ovulation Hormone Test, Pregnanediol Is A By-Product Of Progesterone. During Ovulation Progesterone Increases Significantly To Prepare The Uterus For A Fertilized Egg. Measuring Pregnanediol Is Effective For Charting Ovulation Cycles. |
| 84138-CPT | Low | Hormone Metabolism Test, This Test Is Commonly Referred To As The 17-Oh-Progesterone Test. The Hormone Affects Adrenal Gland Hormone Secretion. |
| 84144-CPT | Low | Progesterone Hormone Test, Progesterone Levels Relate To The Ovulation Cycle And Pregnancy Development. The Test Helps Understand Fertility Problems And Assess Risk Such As Threatened Miscarriage Or Ectopic Pregnancy. |
| 84146-CPT | Low | Prolactin Hormone Test, Prolactin Is A Hormone Made By The Pituitary Gland. It Affects Fertility And Production And Release Of Other Hormones. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84138. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84138 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 84138) and we'll show you how you compare in 15 minutes or less.