CMS Price Transparency Data

Neurobehavioral status check

Facility: St Elizabeth Edgewood

Billing Code: 96116 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$360
about 1.6× the $221 Medicare rate · typically $224–$360
modeled estimate · not a bill or quote
What this hospital charges insurers
$231
Below the fair price — a good deal
about $129 under the fair price · 1.0× Medicare
Medicare pays $221 Fair price $360 This hospital $231

How we calculate the fair BaseRate →

How this hospital compares to other KY hospitals

A typical price — 3 charge more and 4 charge less, among the 9 KY hospitals compared.

Cheapest $105 Priciest $294

Black dot = this hospital, among the 9 KY hospitals with a price for this procedure. Full list below.

A fair price for a Neurobehavioral status check is about $360 (about 1.6× the $221 Medicare rate). St Elizabeth Edgewood charges insurers about $231 — below the fair price — a good deal. Located in Edgewood, KY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield AetnaCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $218 99%
Blue Cross Blue Shieldmajor $214 97%
Ambetter (Centene) $428 194%
Devoted Health $225 102%
WellCare $231 105%
+ 1 smaller / regional plan $475 - $529

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Facility Profile & Credentials

  • Address: 1 Medical Village Drive, Edgewood, KY 41017
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals