CMS Price Transparency Data

Neurobehavioral status check

Facility: Ochsner St Anne General Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $358
Cash Discount Price: $241
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Ochsner St Anne General Hospital is $358. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $241. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.62x the Medicare baseline. Located in 4608 Highway 1, Raceland, LA.

Cash / Self-Pay

$241

Average discount available for prompt cash payment at this facility.

Insurance Median

$358

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: $241 (109%)

Insurance Median: $358 (162%)

Cash: $241 (109% of Medicare)

Ins. Median: $358 (162% 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
Tricare	$153 - $170	69%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$170	77%
Blue Cross Blue Shield	$170 - $365	77%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$170	77%
Humana	$170	77%
Medicare (plans)	$170	77%
Ochsner Health Plan	$170	77%
UnitedHealthcare	$170 - $372	77%
Healthcomp & Personify Health (Formerly Gilsbar)	$411	186%
Louisiana Workers' Compensation Corporation (Lwcc)	$411	186%
Mississippi Physicians Care Network	$411	186%
Employers Health Network (Ehn)	$466	211%
First Health Network	$466	211%
Prime Health Services Ppo	$466	211%
Claritev D/B/A Multiplan/Phcs/American Life Care	$493	223%
Usa Managed Care Network	$493	223%
Zelis	$493	223%
Aetna	$504	228%
Cigna	$524	238%

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 $241.
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 St Anne General Hospital 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.