CMS Price Transparency Data

Neurobehavioral status check

Facility: Lutheran Hospital of Indiana

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $180
  • Cash Discount Price: $79
  • vs. Medicare Baseline: 0.82x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Lutheran Hospital of Indiana is $180. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.82x the Medicare baseline. Located in 7950 W Jefferson Blvd, Fort Wayne, IN.
Cash / Self-Pay
$79

Average discount available for prompt cash payment at this facility.

Insurance Median
$180

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: $79 (36%)
Insurance Median: $180 (82%)
Cash: $79 (36% of Medicare)
Ins. Median: $180 (82% 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
Physicians Health Plan Of Northern Indiana $59 - $95 27%
Ky Work Comp $60 27%
One Call Care Diagnostics $71 32%
Amish Aid $72 33%
Lutheran Preferred Network $72 - $144 33%
Self Pay $72 - $86 33%
Cigna $78 - $87 35%
Php Freedom Network $80 36%
Veterans Eval Services $85 39%
Blue Cross Blue Shield $89 - $939 40%
Aetna $96 - $225 44%
Lutheran Preferred $96 44%
Sagamore $109 - $130 49%
Encore Ppo $117 53%
Lutheran Network $120 - $457 54%
Multiplan $175 - $199 79%
Prime Health Services $180 - $411 82%
Encore Health Network $197 - $216 89%
Advantage Health Solutions $199 90%
UnitedHealthcare $202 - $228 92%
Allied Benefit Systems $216 98%
Evolutions $216 98%
Humana $225 102%
Iu Health Plan $225 102%
Managed Health Services $225 - $457 102%
Medicare (plans) $225 102%
Node Hospice Non Par Agree $228 103%
Node Va $228 103%
Node Devoted Health Mcr Adv $229 104%
In Dept Of Correction $238 108%
Node Pphp Mcr Adv $240 109%
Us Department Of Labor $286 130%
Lutheran Advanced Network $343 155%
Node Lutheran Network $343 - $400 155%
Node Lutheran Preferred Fixed 2 $343 155%
Align Network $366 166%
Encore Work Comp In $411 186%
Node Encore Kba Epo $548 248%
Node Encore Kba Ppo $685 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7950 W Jefferson Blvd, Fort Wayne, IN 46804
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals