CMS Price Transparency Data

Neurobehavioral status check

Facility: Casa Colina Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $156
  • Cash Discount Price: $361
  • vs. Medicare Baseline: 0.71x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Casa Colina Hospital is $156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $361. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.71x the Medicare baseline. Located in 255 E Bonita Ave, Pomona, CA.
Cash / Self-Pay
$361

Average discount available for prompt cash payment at this facility.

Insurance Median
$156

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: $361 (164%)
Insurance Median: $156 (71%)
Cash: $361 (164% of Medicare)
Ins. Median: $156 (71% 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
Medi-Cal $84 38%
Kaiser Mcal $92 42%
Iehp Mcal $115 52%
Heritage Prvdr Ntwrk Mcal $118 53%
Epic Comm - All Other Plans $130 59%
Epic Mcr Adv $130 59%
Iehp Mcr Adv $130 59%
Primecare Comm - All Other Plans $130 59%
Primecare Mcr Adv $130 59%
Capital Hlth Phys Op Only - All Plans $135 61%
Doctors Managed Op Only - All Plans $135 61%
Empire Healthcare Op Only - All Plans $135 61%
Focus Healthcare Wc - All Plans $135 61%
Healthcare Partners - All Other Plans $135 61%
Healthcare Partners Mcr $135 61%
Premiercare Op Only - All Plans $135 61%
Humana $137 - $278 62%
Paramount Ipa Op Only - All Plans $138 63%
Primecare Chino Valley Mcr $138 63%
Heritage Prvdr Ntwrk Comm - All Other Plans $140 63%
Heritage Prvdr Ntwrk Mcr $140 63%
Aetna $143 - $333 65%
Advanced Med Dr Op Only - All Plans $150 68%
Brand New Day Mcr Adv - All Plans $150 68%
Primecare Chino Valley Comm $150 68%
Three Rivers - All Plans $151 68%
Kaiser Comm - All Other Plans $154 70%
Prospect Med Grp Alta - All Plans $155 70%
Healthnet Comm - All Other Plans $156 71%
UnitedHealthcare $158 - $278 72%
Cigna $172 78%
Affiliated Hlth Funds - All Plans $178 81%
Blue Shield Comm - All Other Plans $179 81%
Tricare $181 82%
Blue Cross Blue Shield $197 - $278 89%
Galaxy Provdr Ntwrk - All Plans $211 96%
Corvel - All Plans $219 99%
Coventry - All Plans $219 99%
Multiplan - All Plans $219 99%
Prospect Hp Mcal $250 113%
Promed Hlth Ntwrk Op Only - All Plans $264 120%
Blue Shield Mcr Adv $278 126%
Caremore Mcr Adv - All Plans $278 126%
Central Hlth Plan - All Plans $278 126%
Healthnet Mcr Adv $278 126%
Iehp - All Other Plans $278 126%
Kaiser Mcr Adv $278 126%
Prospect Hp Mcr Adv $278 126%
Triwest - All Plans $278 126%
Wellcare Mcr Adv - All Plans $278 126%
Prospect Hp Comm - All Other Plans $305 138%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 255 E Bonita Ave, Pomona, CA 91767
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals