Neurobehavioral status check
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 96116 (CPT)
- CPT Billing Code: 96116
- Insurance Median: $288
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.31x 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 |
|---|---|---|
| UnitedHealthcare | $89 - $806 | 40% |
| Medicaid / KanCare | $93 | 42% |
| Aetna | $93 | 42% |
| Providrs Care | $116 | 53% |
| Tricare | $177 | 80% |
| Humana | $288 - $291 | 131% |
| Medicare (plans) | $288 - $294 | 131% |
| Va | $288 | 131% |
| Smarthealth | $403 | 183% |
| Ambetter / Centene | $490 | 222% |
Consumer Guidance & Cost Commentary
For the CPT code 96116, representing a neurobehavioral status check at Ascension Via Christi Hospital Manhattan, the facility's negotiated rates range from $89 to $490 depending on the insurance plan. The lowest negotiated rate of $89 is offered by UnitedHealthcare, while the highest is $490 by Ambetter/Centene. This facility is located in Manhattan, Kansas, and its negotiated rates are significantly higher than the state average, which sits at $288.00. While commercial insurance contracts often result in higher prices due to administrative costs and network tiering, patients with high-deductible plans may find that paying cash directly is more cost-effective, as the cash price can sometimes be lower than the insurance negotiated rate. It is important to verify your specific plan's allowed amount before scheduling, as rates vary widely across different carriers.
The Medicare benchmark for this service is $220.60, which serves as a reliable baseline for evaluating the facility's pricing markup. The facility's negotiated rate of $288.00 is approximately 1.3 times the Medicare amount, indicating a markup that is higher than the typical fair pricing range of 120% to 150% of Medicare. Because commercial rates often include administrative overhead and do not reflect the true cost of care, comparing them directly to the hospital's chargemaster list can be misleading. Patients should request an itemized bill to ensure no errors exist, such as unbundled codes or services not rendered, as over 80% of hospital bills contain inaccuracies. Additionally, asking about self-pay or prompt-pay discounts before check-in can help reduce the final