CMS Price Transparency Data

Neurobehavioral status check

Facility: Phoebe Sumter Medical Center

Billing Code: 96116 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$245
about 1.1× the $221 Medicare rate · typically $165–$343
modeled estimate · not a bill or quote
Medicare pays $221 Fair price $245 Cash price $124 Hospital's list price $206

How we calculate the fair BaseRate →

What each insurance company pays

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

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

✓ Aetna UnitedHealthcareBlue Cross Blue ShieldCignaHumanaKaiser 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
Aetnamajor $193 - $293 87%
Ambetter (Centene) $331 150%
Clover Health $195 88%
+ 2 smaller / regional plans $199 - $274

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

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

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 126 Highway 280 W, Americus, GA 31719
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals