CMS Price Transparency Data

Neurobehavioral status check

Facility: Saint Joseph East

Billing Code: 96116 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$357

about 1.6× the $221 Medicare rate · typically $151–$473

modeled estimate · not a bill or quote

What this hospital charges insurers

$320

Below the fair price — a good deal

about $37 under the fair price · 1.4× Medicare

Medicare pays $221 Fair price $357 This hospital $320 Cash price $369 Hospital's list price $918

How we calculate the fair BaseRate →

How this hospital compares to other KY hospitals

Highest price of the 9 KY hospitals we have prices for — worth calling around.

Cheapest $105 Priciest $320

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 $357 (about 1.6× the $221 Medicare rate). Saint Joseph East charges insurers about $320, or about $369 in cash — below the fair price — a good deal. Located in Lexington, KY.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$243 - $698	110%
Blue Cross Blue Shieldmajor	$251 - $306	114%
Aetnamajor	$239 - $578	108%
Cignamajor	$588	267%
Humanamajor	$236 - $306	107%
CareSource	$612	277%
Molina	$224 - $321	102%
WellCare	$234 - $306	106%

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 369), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 96116.

Insurance Before you use insurance

Call your insurance company to confirm Saint Joseph East is in-network.
Ask your insurer whether prior approval is required for CPT code 96116.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Saint Joseph East

Compare: Neurobehavioral status check at other KY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.