CMS Price Transparency Data

Neurobehavioral status check

Facility: Memorial Hospital Miramar

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $375
  • Cash Discount Price: $404
  • vs. Medicare Baseline: 1.70x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Memorial Hospital Miramar is $375. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $404. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.70x the Medicare baseline. Located in 1901 Sw 172Nd Ave, Miramar, FL.
Cash / Self-Pay
$404

Average discount available for prompt cash payment at this facility.

Insurance Median
$375

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: $404 (183%)
Insurance Median: $375 (170%)
Cash: $404 (183% of Medicare)
Ins. Median: $375 (170% 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
Avmed $85 - $178 39%
Amerihealth Caritas $92 42%
UnitedHealthcare $92 - $271 42%
Community Care Plan $98 44%
Cigna $99 - $269 45%
Molina $104 47%
Aetna $115 - $250 52%
Employers Health Network $185 84%
Wellcare $239 - $246 108%
Florida Community Care $241 109%
Sunshine $242 - $428 110%
Humana $244 111%
Solis Health Plan $255 116%
Health Sun $257 - $433 117%
Florida Pace Centers $259 117%
Align Senior Care $275 125%
Longevity $282 128%
Emerging Therapy Solutions $346 157%
Allianz $375 170%
Axis $375 170%
Desjardins Financial Security Life Assurance Company $375 170%
Global Health Claims $375 - $490 170%
Global Medical Management $375 170%
Global Reach Health $375 170%
National Healthcare Solutions $375 170%
Plotkin $375 170%
Quality Health Management $375 170%
Quebec Inc $375 170%
Star Healthcare Network $375 170%
World Medical Care $375 170%
Worldwide Managed Care Partners $375 170%
Worldwide Medical Assurance $375 170%
Dimension Health $389 176%
Employers Choice Network $462 209%
Evernorth $462 209%
Gallagher Bassett $462 209%
Broward County $718 - $2,726 325%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 Sw 172Nd Ave, Miramar, FL 33029
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals