Neurobehavioral status check
Facility: Via Christi Hospital Wichita St Teresa, 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 |
|---|---|---|
| Medicare (plans) | $288 - $294 | 131% |
| Humana | $288 | 131% |
| Vc Hope | $288 | 131% |
| Via Christi Research | $288 | 131% |
| Saint Lukes Health Systems | $288 | 131% |
| Va | $288 | 131% |
| UnitedHealthcare | $294 - $806 | 133% |
| Blue Cross Blue Shield | $294 | 133% |
| Corizon | $360 | 163% |
| Smarthealth | $403 | 183% |
| Medicaid / KanCare | $490 | 222% |
Consumer Guidance & Cost Commentary
For the CPT code 96116, "Neurobehavioral status check," the negotiated rates across 11 payers range from $288 to $806, with a median negotiated amount of $291.00. This facility, Via Christi Hospital Wichita St Teresa, Inc, is a voluntary non-profit church-owned acute care hospital located in Wichita, KS (ZIP 67235). While the data does not provide specific cash or state/county average figures for this service, it is important to note that cash-pay rates can sometimes be lower than insurance negotiated rates, particularly for patients with high-deductible plans. Because insurance contracts often include administrative overhead and multi-layered pricing structures, the final amount a patient owes may depend heavily on their specific plan's deductible status and the facility's self-pay or prompt-pay discounts.
Patients should be aware that Medicare serves as a reliable benchmark for pricing, with the Medicare amount for this code set at $220.60. Commercial negotiated rates frequently exceed this baseline, and while the data indicates a ratio of 1.3 versus Medicare, the actual cost to the patient depends on whether they are in-network and have met their deductible. To avoid unexpected costs, consumers should request a full itemized bill before paying, as summary bills can obscure individual charges. Additionally, if a patient receives care from an out-of-network provider at this in-network facility, the No Surprises Act may protect them from balance billing for emergency or non-emergency services, though they should verify the network status of any ancillary services like labs or emergency physicians.