CMS Price Transparency Data

Neurobehavioral status check

Facility: Ochsner Medical Center - Baton Rouge

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $279
Cash Discount Price: $88
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Ochsner Medical Center - Baton Rouge is $279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $88. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.26x the Medicare baseline. Located in 17000 Medical Center Dr, Baton Rouge, LA.

Cash / Self-Pay

$88

Average discount available for prompt cash payment at this facility.

Insurance Median

$279

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: $88 (40%)

Insurance Median: $279 (126%)

Cash: $88 (40% of Medicare)

Ins. Median: $279 (126% 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
Zelis	$25	11%
Claritev D/B/A Multiplan/Phcs/American Life Care	$164	74%
Healthcomp & Personify Health (Formerly Gilsbar)	$164	74%
Louisiana Workers' Compensation Corporation (Lwcc)	$206	93%
Mississippi Physicians Care Network	$206	93%
Aetna	$219	99%
First Health Network	$219	99%
Prime Health Services Ppo	$233	106%
Usa Managed Care Network	$233	106%
Blue Cross Blue Shield	$240 - $303	109%
Cigna	$258	117%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$286	130%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$286	130%
Humana	$286	130%
Medicare (plans)	$286	130%
Ochsner Health Plan	$286	130%
Tricare	$286	130%
UnitedHealthcare	$286 - $465	130%

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 $88.
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 Ochsner Medical Center - Baton Rouge 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.