CMS Price Transparency Data

Neurobehavioral status check

Facility: Lawrence Memorial Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $125
Cash Discount Price: $249
vs. Medicare Baseline: 0.57x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Lawrence Memorial Hospital is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $249. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.57x the Medicare baseline. Located in 1309 West Main Street, Walnut Ridge, AR.

Cash / Self-Pay

$249

Average discount available for prompt cash payment at this facility.

Insurance Median

$125

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$220.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $220.6 (100%)

Cash / Self-Pay: $249 (113%)

Insurance Median: $125 (57%)

Cash: $249 (113% of Medicare)

Ins. Median: $125 (57% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $220.6 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Ambetter / Centene	$73 - $370	33%
Amerigroup	$73 - $285	33%
Humana	$73 - $288	33%
Allwell	$77 - $299	35%
Blue Cross Blue Shield	$77 - $285	35%
Wellcare	$77 - $500	35%
Arkansas Superior Select	$79 - $168	36%
Provider Partners Health Plans	$79 - $168	36%
Wellcare By Allwell	$79 - $168	36%
Wellcare Health Plans	$79 - $168	36%
Qualchoice	$84 - $370	38%
Qualchoice Of Arkansas	$86 - $208	39%
Cigna	$88 - $285	40%
Covenant Healthcare	$97	44%
Assured Benefits Administrators	$120 - $256	54%
Aetna	$242	110%
Healthlink	$281 - $465	127%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $249.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lawrence Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96116.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.