CMS Price Transparency Data

Neurobehavioral status check

Facility: Lake Charles Memorial Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $255
  • Cash Discount Price: $193
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Lake Charles Memorial Hospital is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $193. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.16x the Medicare baseline. Located in 1701 Oak Park Blvd, Lake Charles, LA.
Cash / Self-Pay
$193

Average discount available for prompt cash payment at this facility.

Insurance Median
$255

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: $193 (87%)
Insurance Median: $255 (116%)
Cash: $193 (87% of Medicare)
Ins. Median: $255 (116% 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.

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
Meritain $145 66%
Verity $155 70%
Ppo_Plus_ $193 87%
Phcs $225 102%
United_Healthcare $225 102%
United_Healthcare_Behavorial_Health $225 102%
Cigna $242 - $255 110%
Lwcc $246 112%
Aetna $255 - $268 116%
Blue Cross Blue Shield $255 116%
Champus_Va $255 116%
Medicare (plans) $255 116%
Tricare $255 116%
Veterans_Administration $255 116%
Veterans_Choice-Triwest $255 116%
First_Health $258 117%
Humana $260 - $268 118%
Coushatta_Tribe_Dept_Of_Health $268 121%
Vantage_Commercial $268 121%
Workers_Compensation $290 131%
Blue_Cross_Blue_Shield_La $507 230%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Oak Park Blvd, Lake Charles, LA 70601
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals