CMS Price Transparency Data

Neurobehavioral status check

Facility: Flagstaff Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $255
  • Cash Discount Price: $156
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Flagstaff Medical Center is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.16x the Medicare baseline. Located in 1200 North Beaver Street, Flagstaff, AZ.
Cash / Self-Pay
$156

Average discount available for prompt cash payment at this facility.

Insurance Median
$255

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: $156 (71%)
Insurance Median: $255 (116%)
Cash: $156 (71% of Medicare)
Ins. Median: $255 (116% 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.

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
Health Choice $91 - $474 41%
University Of Arizona Health Plans $91 - $280 41%
Va Pccc Triwest $93 - $247 42%
Devoted $101 - $255 46%
UnitedHealthcare $109 - $288 49%
Self Pay $156 - $311 71%
Self-Pay 50% Discount $156 71%
Naphcare $163 - $494 74%
Blue Cross Blue Shield $183 - $228 83%
Workers Comp $202 92%
Copperpoint $228 103%
Aetna $230 - $265 104%
Health Net Federal $230 104%
Fmc 30/70 $243 110%
Humana $243 - $296 110%
Medicare (plans) $243 110%
Mercy Care Advantage $243 110%
Rehabilitation Hospital Of Northern Arizona $243 110%
Snf Fmc $243 110%
Wellcare $243 110%
Wellcare By Allwell $243 110%
Fmc Ihs $247 112%
Nau Athletic Department $249 113%
Carefirst $256 116%
Mercy Care Rhba $256 116%
Ahcccs $265 120%
Ahcccs Other $265 120%
Fmc Jail $265 120%
Health Choice Arizona $265 120%
Health Choice Integrated Care $265 120%
Health Net Of Arizona $265 120%
Mercy Care $265 120%
Nhi Out Of State Ahcccs $265 120%
Ambetter / Centene $279 126%
Cigna $280 127%
Fmc 90/10 $280 127%
Rural Arizona Network Multiplan $280 127%
United Behavioral Health $311 141%
Pnoa $364 165%
Auto Insurance $5,000 2267%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 North Beaver Street, Flagstaff, AZ 86001
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals