CMS Price Transparency Data

Neurobehavioral status check

Facility: Phoenix Children's Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $386
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.75x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Phoenix Children's Hospital is $386. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.75x the Medicare baseline. Located in 1919 East Thomas Road, Phoenix, AZ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$386

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%)
Insurance Median: $386 (175%)
Ins. Median: $386 (175% 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
Ahccs $13 - $348 6%
Ahc Apipa $23 10%
Ahc Cmdp $23 10%
Ahc Crs $23 - $348 10%
Ahc Ihs $23 10%
Ahc Mercy Care $23 10%
Ahc University $26 12%
Ahc Healthchoice $182 83%
Ahc Lcd $192 87%
Ahc Care First $348 158%
Healthcomp $386 175%
Intel $386 175%
Cigna $402 - $772 182%
UnitedHealthcare $420 - $456 190%
Aetna $442 - $707 200%
Antidote $627 284%
Blue Cross Blue Shield $685 - $927 311%
Multiplan $772 350%
Selfpay $773 350%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1919 East Thomas Road, Phoenix, AZ 85016
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens