CMS Price Transparency Data

Neurobehavioral status check

Facility: The Women's Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $111
Cash Discount Price: $72
vs. Medicare Baseline: 0.50x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at The Women's Hospital is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.50x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $72 (33%)

Insurance Median: $111 (50%)

Cash: $72 (33% of Medicare)

Ins. Median: $111 (50% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$64 - $160	29%
Humana	$64 - $280	29%
Passport Molina Ky	$64	29%
UnitedHealthcare	$64 - $280	29%
Wellcare Ky	$64 - $280	29%
Amish	$72 - $112	33%
Self Pay	$72	33%
Blue Cross Blue Shield	$74 - $1,025	34%
Caresource	$74 - $280	34%
Iu Health	$74 - $280	34%
Meridian Health Il	$74 - $280	34%
Mhs	$74 - $280	34%
Molina Il	$74 - $280	34%
Molina Ky	$74 - $280	34%
Molina Ky Dual	$74 - $280	34%
Ambetter / Centene	$85 - $434	39%
Caresource Hip	$87	39%
Caresource In	$87	39%
Mdwise Hip	$87	39%
Mhs Behavioral	$87	39%
Immergrun	$90	41%
Caresource Marketplace (Just4Me)	$96 - $420	44%
Patoka Valley Health Care (80/20 Plan)	$96	44%
Patoka Valley Health Care (90/10 Plan)	$96	44%
Hst	$100 - $420	45%
Alliance Coal	$102	46%
Allied National/Zelis - Freedom Plan	$104 - $685	47%
Claimdoc	$107 - $406	49%
One Care	$111	50%
Chamber Care	$113	51%
Encorecombined	$115	52%
Encoreprime	$115	52%
Hope Trust	$119 - $462	54%
Noncontracted	$119 - $448	54%
Center Care	$124	56%
Cigna	$160	73%
Claritev (Formerly Phcs/Mulitplan)	$160	73%
First Health/Coventry	$160	73%
Healthlink	$160	73%
Sagamore	$160	73%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $72.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm The Women's Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96116.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.