Neurobehavioral status check
Facility: Menorah Medical Center
Billing Code: 96116 (CPT)
- CPT Billing Code: 96116
- Insurance Median: $92
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.42x 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 |
|---|---|---|
| United | $89 - $265 | 40% |
| Amerigroup | $89 | 40% |
| Healthyblue | $91 | 41% |
| Medicaid / KanCare | $92 | 42% |
| Aetna | $93 | 42% |
| Unicare | $93 | 42% |
| Home State Health Plan | $279 | 126% |
Consumer Guidance & Cost Commentary
For the CPT code 96116, "Neurobehavioral status check," Menorah Medical Center in Overland Park, KS, has a negotiated rate of $92.00 across seven payers, with the lowest allowed amount being $89.00. This negotiated rate is significantly higher than the Medicare benchmark of $220.60, which serves as the federal baseline for evaluating hospital pricing markups. While commercial rates often average 200% to 300% of Medicare, this specific code shows a negotiated rate that is only 40% higher than the Medicare amount, suggesting a relatively fair pricing structure compared to typical commercial markups. Patients should note that while the facility is a Proprietary Acute Care Hospital, the cash and median paid values are not currently available in the data, so the negotiated rate remains the primary reference for in-network coverage.
For patients with high-deductible plans, it is important to understand that paying cash upfront can sometimes be cheaper than the insurance negotiated rate if the facility offers a prompt-pay discount. Since the facility does not list a specific cash price, you should contact Menorah Medical Center directly to inquire about self-pay or prompt-pay discounts, which can range from 20% to 50% off the billed amount. Additionally, because the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, you can be confident that you will not be billed for the difference between the chargemaster and the allowed amount for this service. Always request an itemized bill before paying to ensure no unbundled codes or services not rendered are included in the final charge.