CMS Price Transparency Data

Neurobehavioral status check

Facility: University of Colorado Hospital Authority

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $416
Cash Discount Price: $296
vs. Medicare Baseline: 1.89x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at University of Colorado Hospital Authority is $416. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $296. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.89x the Medicare baseline. Located in 12605 E 16Th Ave, Aurora, CO.

Cash / Self-Pay

$296

Average discount available for prompt cash payment at this facility.

Insurance Median

$416

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: $296 (134%)

Insurance Median: $416 (189%)

Cash: $296 (134% of Medicare)

Ins. Median: $416 (189% 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	$132 - $681	60%
Select Health	$222 - $313	101%
Rocky Mountain Health Plan	$273 - $437	124%
UnitedHealthcare	$304 - $1,635	138%
Denver Health Medical Plan	$310 - $454	141%
Aetna	$313 - $422	142%
Cigna	$313 - $445	142%
Cms	$313	142%
Devoted Health	$313	142%
Humana	$313	142%
Kaiser	$313 - $503	142%
Simplified Benefits Administration	$324 - $353	147%
Kaiser Public Option	$327 - $335	148%
Phcs	$460 - $471	209%
Multiplan	$502 - $514	228%
First Health	$586 - $600	266%
Midlands Choice	$586 - $600	266%

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 $296.
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 University of Colorado Hospital Authority 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.