CMS Price Transparency Data

Neurobehavioral status check

Facility: Loma Linda University Medical Center-Murrieta

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $435
Cash Discount Price: $460
vs. Medicare Baseline: 1.97x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Loma Linda University Medical Center-Murrieta is $435. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $460. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.97x the Medicare baseline. Located in 28062 Baxter Road, Murrieta, CA.

Cash / Self-Pay

$460

Average discount available for prompt cash payment at this facility.

Insurance Median

$435

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: $460 (209%)

Insurance Median: $435 (197%)

Cash: $460 (209% of Medicare)

Ins. Median: $435 (197% 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
Inland Empire Health Plan (Iehp)	$91 - $396	41%
Trivalley Medical Group	$125	57%
Kaiser Foundation Hospitals	$185 - $488	84%
Adventist Health	$205 - $419	93%
UnitedHealthcare	$220 - $261	100%
Lluh Dept Of Risk Management	$256	116%
Blue Shield Of California	$284 - $354	129%
Blue Cross Blue Shield	$334	151%
Alpha Care Medical Group	$396 - $593	180%
Dignity Health	$396 - $593	180%
Epic Health Plan	$396 - $665	180%
Vantage Medical Group	$396 - $593	180%
Molina Healthcare Of Ca	$499	226%
Aetna	$547 - $703	248%
Heritage Provider Network	$633 - $693	287%
Cigna	$665	301%
Multiplan	$767	348%

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 $460.
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 Loma Linda University Medical Center-Murrieta 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.