CMS Price Transparency Data

Neurobehavioral status check

Facility: HCA Florida Lawnwood Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $574
  • Cash Discount Price: $1,617
  • vs. Medicare Baseline: 2.60x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at HCA Florida Lawnwood Hospital is $574. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,617. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 2.60x the Medicare baseline. Located in 1700 S 23Rd St, Fort Pierce, FL.
Cash / Self-Pay
$1,617

Average discount available for prompt cash payment at this facility.

Insurance Median
$574

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: $1,617 (733%)
Insurance Median: $574 (260%)
Cash: $1,617 (733% of Medicare)
Ins. Median: $574 (260% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 260% of the Medicare baseline (a markup of 160%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Careworks (Rockport) $15 - $95 7%
Corvel Corporation $15 - $93 7%
Prime Health $15 - $1,455 7%
Vail Health $246 112%
Kaiser $323 - $574 146%
United $335 - $728 152%
Cigna $378 - $1,035 171%
Pinnacol Workers Comp $483 219%
Bright Health $485 220%
Multiplan $503 - $1,455 228%
Aetna $527 - $854 239%
Western Plains Community Health $1,051 476%
Northcare $1,132 513%
Physician Health Partners $1,132 513%
Blue Cross Blue Shield $1,197 543%
Medical Development International $1,294 587%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1700 S 23Rd St, Fort Pierce, FL 34950
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals