CMS Price Transparency Data

Neurobehavioral status check

Facility: Adventist Health Delano

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $299
Cash Discount Price: $96
vs. Medicare Baseline: 1.36x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Adventist Health Delano is $299. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.36x the Medicare baseline. Located in 1401 Garces Highway, Delano, CA.

Cash / Self-Pay

$96

Average discount available for prompt cash payment at this facility.

Insurance Median

$299

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: $96 (44%)

Insurance Median: $299 (136%)

Cash: $96 (44% of Medicare)

Ins. Median: $299 (136% 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	$72 - $398	33%
Dignty Hlth Mcal Op Only	$84	38%
Kaiser Medi-Cal Ip/Op Only	$84	38%
Medi-Cal	$84	38%
Universal Care Mcal	$84	38%
Healthnet Medi-Cal	$100	45%
Blue Shield Epn - All Other Plans	$105	48%
Kern Health System Mcal	$108	49%
Bakersfield Fam Med Grp-All Plans	$278	126%
Healthnet Mcr Adv	$278	126%
Kern Mcr Adv Dual Dnsp-All Other Plans	$278	126%
Medicare (plans)	$278 - $444	126%
Tricare	$278	126%
UnitedHealthcare	$278 - $344	126%
Universal Care Mcr- All Other Plans	$278	126%
Coventry- All Plans	$287	130%
Blue Shield Non-Epn	$311	141%
Healthnet- All Other Plans	$322	146%
County Of Kern Network - All Plans	$335	152%
Gem Care- All Plans	$335	152%
Aetna	$353	160%
Foundation For Medical Care Of Kern County - All P	$358	162%
Cigna	$382	173%
Western Growers - All Plans	$387	175%
Kaiser Comm Ip/Op Only- All Other Plans	$478	217%
Ah Employee Health Plan - All Plans	$500	227%
Centivo - All Plans	$625	283%

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 $96.
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 Delano 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.