CMS Price Transparency Data

Neurobehavioral status check

Facility: Children's Hospital Colorado

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $403
  • Cash Discount Price: $397
  • vs. Medicare Baseline: 1.83x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Children's Hospital Colorado is $403. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $397. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.83x the Medicare baseline. Located in 13123 E 16Th Ave, Aurora, CO.
Cash / Self-Pay
$397

Average discount available for prompt cash payment at this facility.

Insurance Median
$403

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: $397 (180%)
Insurance Median: $403 (183%)
Cash: $397 (180% of Medicare)
Ins. Median: $403 (183% 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
Ccha Behavioral Health $49 - $73 22%
Integrated Health Plan $73 - $110 33%
Denver Health Medical Plan $102 - $549 46%
Kaiser $166 - $534 75%
Rocky Mountain Health Plan Behavioral Health $195 - $293 88%
Carelon Behavioral Health $220 - $512 100%
Presbyterian Health Plan $234 - $417 106%
Colorado Access $239 - $359 108%
Colorado Access Behavioral Health $239 - $359 108%
Molina Healthcare Of Nebraska $268 - $403 121%
Molina Healthcare Of New Mexico $268 - $403 121%
Peak Health Alliance/Ebms $268 - $439 121%
Rocky Mountain Health Plan $268 - $476 121%
Healthy Blue Of Nebraska $283 - $425 128%
Humana $298 - $512 135%
UnitedHealthcare $304 - $490 138%
Evernorth Behavioral Health $317 - $476 144%
Interlink National $317 - $549 144%
Blue Cross Blue Shield $327 - $549 148%
Centivo $337 - $505 153%
Select Health $342 - $512 155%
Uchealth Plan Administrators $342 - $512 155%
Cigna $352 - $528 160%
Aetna $356 - $586 161%
Department Of Corrections $381 - $571 173%
Comppsych Behavioral Health $415 - $622 188%
First Choice Health $415 - $622 188%
Midlands Choice $415 - $622 188%
National Preferred Provider Network $415 - $622 188%
Multiplan $420 - $630 190%
Cofinity $439 - $659 199%
First Choice Of The Midwest $439 - $659 199%
Usa Managed Care Organization $439 - $659 199%
First Health Network $449 - $673 204%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13123 E 16Th Ave, Aurora, CO 80045
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens