CMS Price Transparency Data

Neurobehavioral status check

Facility: Valleywise Health Medical Center

Billing Code: 96116 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$125

about 0.6× the $221 Medicare rate · typically $84–$225

modeled estimate · not a bill or quote

What this hospital charges insurers

$107

Below the fair price — a good deal

about $18 under the fair price · 0.5× Medicare

Medicare pays $221 Fair price $125 This hospital $107 Cash price $265 Hospital's list price $335

How we calculate the fair BaseRate →

How this hospital compares to other AZ hospitals

One of the lower prices — 6 of 8 other AZ hospitals charge more for the same procedure.

Cheapest $76 Priciest $294

Black dot = this hospital, among the 9 AZ hospitals with a price for this procedure. Full list below.

A fair price for a Neurobehavioral status check is about $125 (about 0.6× the $221 Medicare rate). Valleywise Health Medical Center charges insurers about $107, or about $265 in cash — below the fair price — a good deal. Located in Phoenix, AZ.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$80 - $356	36%
Blue Cross Blue Shieldmajor	$72 - $462	33%
Aetnamajor	$72 - $312	33%
Cignamajor	$88 - $384	40%
Humanamajor	$83 - $230	38%
Banner Health	$72 - $230	33%
Devoted Health	$72 - $230	33%
Health Net	$61 - $441	28%
Molina	$76 - $253	34%
Oscar Health	$83 - $249	38%
+ 12 smaller / regional plans	$66 - $1,049

Government programs also on file: Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 265), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 96116.

Insurance Before you use insurance

Call your insurance company to confirm Valleywise Health Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 96116.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Valleywise Health Medical Center

Compare: Neurobehavioral status check at other AZ hospitals

Insurance negotiated median for the same procedure, sorted lowest first.