CMS Price Transparency Data

Neurobehavioral status check

Facility: Norton Hospitals, Inc

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $292
Cash Discount Price: $85
vs. Medicare Baseline: 1.32x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Norton Hospitals, Inc is $292. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.32x the Medicare baseline. Located in 200 East Chestnut Street, Louisville, KY.

Cash / Self-Pay

$85

Average discount available for prompt cash payment at this facility.

Insurance Median

$292

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$220.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $220.6 (100%)

Cash / Self-Pay: $85 (39%)

Insurance Median: $292 (132%)

Cash: $85 (39% of Medicare)

Ins. Median: $292 (132% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
UnitedHealthcare	$70 - $394	32%
Aetna	$81 - $313	37%
Passport	$85	39%
Humana	$102 - $192	46%
Siho	$149 - $320	68%
Cigna	$159 - $287	72%
Blue Cross Blue Shield	$181 - $371	82%
Wellcare	$292	132%
Siho In Exchange	$299	136%
Multiplan	$333 - $363	151%
Correct Care	$354	160%
Correct Care Ob & Gyn	$354	160%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $85.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Norton Hospitals, Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96116.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.