CMS Price Transparency Data

Neurobehavioral status check

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 96116 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$97

about 0.4× the $221 Medicare rate · typically $80–$215

modeled estimate · not a bill or quote

What this hospital charges insurers

$105

About the fair price

about $8 over the fair price · 0.5× Medicare

Medicare pays $221 Fair price $97 This hospital $105 Cash price $436 Hospital's list price $670

How we calculate the fair BaseRate →

How this hospital compares to other FL hospitals

Highest price of the 9 FL hospitals we have prices for — worth calling around.

Cheapest $53 Priciest $105

Black dot = this hospital, among the 9 FL hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Neurobehavioral status check is about $97 (about 0.4× the $221 Medicare rate). Cleveland Clinic Indian River Hospital charges insurers about $105, or about $436 in cash — about the fair price. Located in Vero Beach, FL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$66 - $313	30%
Blue Cross Blue Shieldmajor	$76 - $313	34%
Aetnamajor	$94 - $603	43%
Cignamajor	$89 - $114	40%
Humanamajor	$313	142%
AmeriHealth	$70	32%
AvMed	$78 - $716	35%
Devoted Health	$344	156%
Molina	$70	32%
WellCare	$70 - $313	32%
WellMed	$82 - $313	37%
+ 11 smaller / regional plans	$64 - $502

Government programs also on file: Medicaid.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 436), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 96116.

Insurance Before you use insurance

Call your insurance company to confirm Cleveland Clinic Indian River Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 96116.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Cleveland Clinic Indian River Hospital

Compare: Neurobehavioral status check at other FL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.