CMS Price Transparency Data

Neurobehavioral status check

Facility: Saint Joseph's Hospital of Atlanta, Inc

Billing Code: 96116 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$319

about 1.4× the $221 Medicare rate · typically $197–$510

modeled estimate · not a bill or quote

What this hospital charges insurers

$226

Below the fair price — a good deal

about $93 under the fair price · 1.0× Medicare

Medicare pays $221 Fair price $319 This hospital $226 Cash price $826 Hospital's list price $826

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

Highest price of the 9 GA hospitals we have prices for — worth calling around.

Cheapest $88 Priciest $226

Black dot = this hospital, among the 9 GA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Neurobehavioral status check is about $319 (about 1.4× the $221 Medicare rate). Saint Joseph's Hospital of Atlanta, Inc charges insurers about $226, or about $826 in cash — below the fair price — a good deal. Located in Atlanta, GA.

What each insurance company pays

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

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

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna UnitedHealthcareHumanaKaiser 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
Blue Cross Blue Shieldmajor	$222	101%
Aetnamajor	$224	102%
Cignamajor	$226	102%
Ambetter (Centene)	$465	211%
Clover Health	$230	104%
Devoted Health	$219	99%
WellCare	$232	105%

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 826), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 96116.

Insurance Before you use insurance

Call your insurance company to confirm Saint Joseph's Hospital of Atlanta, Inc is in-network.
Ask your insurer whether prior approval is required for CPT code 96116.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

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

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Saint Joseph's Hospital of Atlanta, Inc

Compare: Neurobehavioral status check at other GA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.