Neurobehavioral status check
Facility: Ascension Via Christi Rehabilitation Hospital 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 |
|---|---|---|
| Aetna | $255 | 116% |
| Humana | $288 | 131% |
| Medicare (plans) | $288 - $294 | 131% |
| Va | $288 | 131% |
| Vc Hope | $288 | 131% |
| Blue Cross Blue Shield | $294 | 133% |
| UnitedHealthcare | $294 - $806 | 133% |
| 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 median negotiated rate of $291.00 across nine payers. This rate is notably higher than the Medicare benchmark of $220.60, reflecting a markup of 1.3 times the federal standard. While commercial insurance plans like UnitedHealthcare and UnitedHealthcare offer negotiated rates ranging from $294 to $806, patients with high-deductible plans may find that paying cash upfront is more cost-effective, as the cash price often falls below the insurance allowed amount. It is important to note that cash rates are not explicitly listed in this report, so patients should directly contact Ascension Via Christi Rehabilitation Hospital Inc to inquire about self-pay or prompt-pay discounts, which can significantly reduce the final bill.
The data indicates that while most payers have a consistent low-end rate of $288, UnitedHealthcare presents a wider range, with plans paying as high as $806. This variation highlights the importance of verifying your specific plan's negotiated rate before scheduling, as in-network status does not guarantee the lowest possible price. To ensure you are not overcharged, we recommend requesting a full itemized billing audit before settling any balance, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, if you receive a balance bill for out-of-network ancillary services, you may be eligible for protections under the No Surprises Act, which bans surprise billing for non-emergency care at in-network facilities.