CMS Price Transparency Data

Neurobehavioral status check

Facility: Adventist Health Reedley

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $103
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 0.47x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Adventist Health Reedley is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.47x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$103

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: $40 (18%)
Insurance Median: $103 (47%)
Cash: $40 (18% of Medicare)
Ins. Median: $103 (47% 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
Healthnet Medi-Cal $29 - $34 13%
Bc Mcal $56 - $83 25%
Cal Viva Hlth Mcal - All Plans $56 - $84 25%
Central Ca Alliance Mcal Profee Only $56 25%
Dignity Mcal Op/Profee Only-All Other Plans $56 - $92 25%
Medi-Cal $56 - $84 25%
Upn Mcal Profee Only-All Other Plans $56 25%
Kern Health Systems Mcal-All Plans $70 - $84 32%
Blue Shield Mcare $73 - $278 33%
Fhcn Pace Mcr Adv-All Plans $73 - $278 33%
Lasalle Med Assoc Profee Only - All Plans $73 33%
Tricare $73 - $278 33%
UnitedHealthcare $73 - $935 33%
Upn Mcr Adv Profee Only $73 33%
Ah Employee Health Plan - All Plans $80 - $500 36%
Blue Cross Blue Shield $81 - $193 37%
Central Ca Alliance Ccs Profee Only $84 38%
Central Ca Alliance Comm Profee Only - All Other P $84 38%
Healthnet- All Other Plans $84 - $106 38%
Community Care Ipa Mcal-All Plans $88 - $109 40%
Aetna $89 - $458 40%
Western Growers/Pinnacle- All Plans $89 - $104 40%
Kaiser - All Other Plans $97 - $114 44%
Cigna $98 - $148 44%
Kaiser Mcr Adv $99 - $278 45%
Blue Shield Epn - All Other Plans $105 - $152 48%
Central Ca Alliance Chdp Profee Only $112 51%
Blue Shield Non Epn $121 - $161 55%
Physicians Med Group Op/Profee Only- All Plans $155 - $182 70%
Dignity Mcr Adv Op/Profee Only $278 126%
Healthnet- Mcr Adv $278 126%
Phs Prime Health Srvcs $278 126%
Bright Health Mcr Adv - All Plans $436 198%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 372 W Cypress Ave, Reedley, CA 93654
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals