CMS Price Transparency Data

Neurobehavioral status check

Facility: Parkview Community Hospital Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $257
Cash Discount Price: $400
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Parkview Community Hospital Medical Center is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $400. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.17x the Medicare baseline. Located in 3865 Jackson Street, Riverside, CA.

Cash / Self-Pay

$400

Average discount available for prompt cash payment at this facility.

Insurance Median

$257

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: $400 (181%)

Insurance Median: $257 (117%)

Cash: $400 (181% of Medicare)

Ins. Median: $257 (117% 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
Blue Cross Blue Shield	$45 - $668	20%
Blue Shield	$45 - $278	20%
Medi-Cal	$45	20%
Health Net	$56 - $394	25%
Molina Medi-Cal	$56	25%
Regal	$67 - $200	30%
Blue Shield Ppo	$116	53%
Ahmc	$120	54%
UnitedHealthcare	$144 - $525	65%
Aetna	$160 - $278	73%
Iehp	$222 - $355	101%
Central Health Plan	$246	112%
Humana	$268	121%
Alignment	$273	124%
Medicare (plans)	$273	124%
Champus	$278	126%
Molina Covered Ca	$278	126%
Molina Senior	$278	126%
Scan	$278	126%
Self Pay	$400	181%

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 $400.
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 Parkview Community Hospital Medical Center 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.