Neurobehavioral status check
Facility: Kingman Healthcare Center
Billing Code: 96116 (CPT)
- CPT Billing Code: 96116
- Insurance Median: $88
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.40x 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 |
|---|---|---|
| Triwest | $74 | 34% |
| Medicaid / KanCare | $88 | 40% |
| Healthy Blue | $88 | 40% |
Consumer Guidance & Cost Commentary
For the CPT code 96116, "Neurobehavioral status check," Kingman Healthcare Center in Kingman, KS, has a median negotiated rate of $88.00 across three payers, including Triwest, Medicaid/KanCare, and Healthy Blue. This rate aligns exactly with the lowest and highest values reported for each insurer, indicating a uniform contract price. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the data does not provide a specific cash-pay or self-pay rate. In cases where a patient has a high deductible or limited insurance coverage, the cash price could potentially be lower than the negotiated rate of $88.00, making it worth asking the hospital directly about self-pay or prompt-pay discounts before scheduling.
The Medicare benchmark for this service is $220.60, which serves as a baseline for evaluating pricing fairness. Although the data does not list a specific county or state average for this procedure, the facility's negotiated rate of $88.00 is significantly below the Medicare amount, suggesting a favorable rate relative to the federal cost basis. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is still important to request an itemized bill to ensure no unbundled charges or services not rendered are included. If a summary bill is received, patients should demand a full CPT-coded statement to verify the accuracy of the charges before making any payment.