CMS Price Transparency Data

Neurobehavioral status check

Facility: Rush University Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $621
  • Cash Discount Price: $502
  • vs. Medicare Baseline: 2.82x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Rush University Medical Center is $621. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $502. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 2.82x the Medicare baseline. Located in 1653 West Congress Parkway, Chicago, IL.
Cash / Self-Pay
$502

Average discount available for prompt cash payment at this facility.

Insurance Median
$621

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: $502 (228%)
Insurance Median: $621 (282%)
Cash: $502 (228% of Medicare)
Ins. Median: $621 (282% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 282% of the Medicare baseline (a markup of 182%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $238 - $1,003 108%
Molina Fide-Snp $241 109%
Meridian Dnsp $243 110%
Cigna $278 - $1,003 126%
Ambetter / Centene $312 141%
Molina Exch - All Other Plans $315 143%
Blue Cross Blue Shield $321 - $1,003 146%
UnitedHealthcare $568 - $1,354 257%
County Care Mcaid - All Plans $733 332%
Meridian Mcaid - All Other Plans $733 332%
Molina Mcaid $777 352%
Devoted Mcr Adv - All Plans $1,003 455%
Humana $1,003 455%
Wellcare Mcr Adv - All Plans $1,003 455%
Zing Hlth Mcr Adv - All Plans $1,063 482%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1653 West Congress Parkway, Chicago, IL 60612
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals