Neurobehavioral status check
Facility: Ascension Via Christi Hospitals Wichita, Inc.
Billing Code: 96116 (CPT)
- CPT Billing Code: 96116
- Insurance Median: $291
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.32x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Saint Lukes Health Systems | $288 | 131% |
| Humana | $288 | 131% |
| Va | $288 | 131% |
| Via Christi Research | $288 | 131% |
| Medicare (plans) | $288 - $294 | 131% |
| Vc Hope | $288 | 131% |
| Blue Cross Blue Shield | $294 | 133% |
| UnitedHealthcare | $294 - $806 | 133% |
| Corizon | $360 | 163% |
| Smarthealth | $403 | 183% |
| Medicaid / KanCare | $490 | 222% |
Consumer Guidance & Cost Commentary
For the CPT code 96116, "Neurobehavioral status check," the facility in Wichita, KS, has a negotiated rate range of $288 to $806 depending on the insurance carrier. While the lowest negotiated rates align with the Medicare benchmark of $220.60, the highest rate of $806 from UnitedHealthcare represents a significant markup compared to the federal baseline. It is important to note that cash-pay options are not listed for this service, so patients relying on out-of-pocket payment should inquire directly with the hospital about self-pay or prompt-pay discounts, which can sometimes reduce the final cost even when insurance rates appear high.
The facility is a voluntary non-profit acute care hospital in Wichita, and while the data does not provide a specific county or state average for this procedure, the Medicare benchmark serves as the objective baseline for evaluating pricing fairness. Commercial negotiated rates often average between 200% and 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of this benchmark. Patients should be aware that assuming an in-network rate is the lowest possible price is a common pitfall, as different insurers negotiate vastly different amounts; therefore, verifying the allowed amount before scheduling is essential to avoid unexpected costs.