CMS Price Transparency Data

Neurobehavioral status check

Facility: Grady Memorial Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $135
  • Cash Discount Price: $705
  • vs. Medicare Baseline: 0.61x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Grady Memorial Hospital is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $705. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.61x the Medicare baseline. Located in 80 Jesse Hill, Jr Drive Se, Atlanta, GA.
Cash / Self-Pay
$705

Average discount available for prompt cash payment at this facility.

Insurance Median
$135

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: $705 (320%)
Insurance Median: $135 (61%)
Cash: $705 (320% of Medicare)
Ins. Median: $135 (61% 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
Aetna $77 - $314 35%
Ambetter / Centene $77 - $310 35%
Blue Cross Blue Shield $77 - $564 35%
Cigna $77 - $423 35%
Humana $77 - $310 35%
Kaiser $77 - $534 35%
Medicare (plans) $77 - $310 35%
UnitedHealthcare $77 - $508 35%
Vaccn $77 - $310 35%
Wellcare $77 - $310 35%
Clear Spring Health $80 - $325 36%
Clover $80 - $325 36%
Usp Naphcare $84 - $573 38%
Amerigroup $91 - $115 41%
Caresource $91 - $496 41%
Peach State $91 - $105 41%
Oscar Health $109 - $514 49%
Multiplan $543 246%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 80 Jesse Hill, Jr Drive Se, Atlanta, GA 30303
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals