CMS Price Transparency Data

Neurobehavioral status check

Facility: Boulder Community Health

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $145
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.66x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Boulder Community Health is $145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.66x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$145

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%)
Insurance Median: $145 (66%)
Ins. Median: $145 (66% 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
UnitedHealthcare $77 - $322 35%
Humana $78 - $313 35%
Aetna $90 - $313 41%
Blue Cross Blue Shield $90 - $1,182 41%
Devoted Health $90 - $313 41%
Health Spring $90 - $313 41%
Medicare (plans) $90 - $322 41%
Clear Spring $93 - $322 42%
Medicaid / KanCare $100 - $105 45%
Rocky Mountain Health Maintenance Organization $100 - $322 45%
Colorado Community Health Alliance (Ccha) $105 48%
Colorado Access $110 - $137 50%
Beech Street Community Medical Associates $121 55%
Select Health Colorado Public Option $126 - $688 57%
Select Health Value Network $126 - $729 57%
Multiplan $127 58%
Phcs $127 58%
Cigna $128 58%
Kaiser Ppo $139 - $737 63%
Kaiser Public Option $139 - $600 63%
Kaiser $733 332%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4747 Arapahoe Avenue, Boulder, CO 80304
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals