CMS Price Transparency Data

Neurobehavioral status check

Facility: Gibson General Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $100
Cash Discount Price: $72
vs. Medicare Baseline: 0.45x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Gibson General Hospital is $100. 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 0.45x the Medicare baseline. Located in 1808 Sherman Drive, Princeton, IN.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $100 (45%)

Cash: $72 (33% of Medicare)

Ins. Median: $100 (45% 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
Ky Racing Health & Welfare Fund	$72	33%
Self-Pay	$72	33%
Aetna	$74 - $160	34%
Blue Cross Blue Shield	$74 - $87	34%
Caresource Just For Me	$74	34%
Medicare (plans)	$74	34%
Meridiancomplete (Il)	$74	34%
Mytruadvantage	$74	34%
UnitedHealthcare	$74 - $154	34%
Va Ccn	$74	34%
Caresource	$87	39%
Mdwise Plans	$87	39%
Mhs	$87	39%
Ambetter / Centene	$93	42%
Caresource In Marketplace	$96	44%
Alliance Coal	$104	47%
Claimdoc	$104	47%
Deaconess Onecare	$111 - $678	50%
Hopetrust	$111	50%
Hstechnology	$111	50%
Chambercare	$115	52%
Encircle/Encore Combined	$115	52%
Encircle/Encore Prime	$115	52%
Noncontracted	$119	54%
Cigna	$160	73%
First Health	$160	73%
Healthlink Hmo	$160	73%
Healthlink Ppo	$160	73%
Sagamore (Ppo, Oap-Open Access Plus, Epo, Choice Fund Oap+)	$160	73%
Gibson County Sheriff	$175	79%
Integrated Health	$185	84%
Principal Health Care	$185	84%

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 Gibson General 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.