CMS Price Transparency Data

Neurobehavioral status check

Facility: Adventist Health Bakersfield

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $88
Cash Discount Price: $29
vs. Medicare Baseline: 0.40x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Adventist Health Bakersfield is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $29. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.40x the Medicare baseline. Located in 2615 Chester Avenue, Bakersfield, CA.

Cash / Self-Pay

$29

Average discount available for prompt cash payment at this facility.

Insurance Median

$88

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: $29 (13%)

Insurance Median: $88 (40%)

Cash: $29 (13% of Medicare)

Ins. Median: $88 (40% 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
Bc Medi-Cal	$56	25%
Medi-Cal	$56	25%
Universal Hc Mcal Profee Only	$56	25%
Blue Shield Mcr Adv	$73	33%
Fhcn Pace Mcr Adv - All Plans	$73	33%
Gem Care- All Plans	$73	33%
Healthnet Mcr Adv	$73	33%
Kern Legacy Share Select	$73	33%
Oscar - All Plans	$73	33%
Premier Physician Alliance Profee Only-All Plans	$73	33%
UnitedHealthcare	$73 - $109	33%
Kern Health Systems Mcal	$79	36%
County Of Kern - All Plans	$81	37%
Employee Health Plan - All Plans	$81	37%
Kern Legacy Hp Epo - All Other Plans	$81	37%
Aetna	$88	40%
Network Provdrs Llc Mcare -All Payers	$95	43%
Western Growers/Pinnacle- All Plans	$102	46%
Cigna	$106	48%
Healthnet Hmo/Pos/Ppo/Epo - All Other Plans	$107	49%
Centivo - All Plans	$110	50%
Blue Shield Epn	$152	69%
Blue Shield Epo/Ppo	$161	73%
Blue Shield Hmo/Pos - All Other Plans	$161	73%
Blue Cross Blue Shield	$195	88%
Universal Health Plan Mcare-All Other Plans	$278	126%

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 $29.
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 Adventist Health Bakersfield 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.