CMS Price Transparency Data

Neurobehavioral status check

Facility: Cleveland Clinic Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $313
Cash Discount Price: $1,005
vs. Medicare Baseline: 1.42x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Cleveland Clinic Hospital is $313. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,005. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.42x the Medicare baseline. Located in 3100 Weston Rd, Weston, FL.

Cash / Self-Pay

$1,005

Average discount available for prompt cash payment at this facility.

Insurance Median

$313

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: $1,005 (456%)

Insurance Median: $313 (142%)

Cash: $1,005 (456% of Medicare)

Ins. Median: $313 (142% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$66	30%
Medicaid / KanCare	$70	32%
United	$70 - $1,881	32%
Blue Cross Blue Shield	$71 - $313	32%
Avmed	$78 - $675	35%
Doctors Health Plan	$78 - $313	35%
Wellcare	$78 - $313	35%
Independent Living Systems	$82 - $328	37%
Clear Spring Health	$84 - $117	38%
Cigna	$89 - $676	40%
Aetna	$97 - $1,602	44%
Humana	$313	142%
Maritime	$335 - $1,212	152%
Multiplan	$335 - $2,060	152%
Devoted Health	$344	156%
Clarity Health	$436 - $1,575	198%
The Legacy Companies	$436 - $1,575	198%
Consociate Health	$502	228%
Bmi	$1,333	604%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,005.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Cleveland Clinic Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96116.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.