CMS Price Transparency Data
Neurobehavioral status check
Facility: Cambridge Health Alliance
Billing Code: 96116 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 96116
- Insurance Median: $313
- Cash Discount Price: $257
- vs. Medicare Baseline: 1.42x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Cambridge Health Alliance is $313. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $257. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.42x the Medicare baseline. Located in 1493 Cambridge Street, Cambridge, MA.
Cash / Self-Pay
$257
Average discount available for prompt cash payment at this facility.
Insurance Median
$313
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: $257 (117%)
Insurance Median: $313 (142%)
Cash: $257 (117% of Medicare)
Ins. Median: $313 (142% 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Wc [90001] | $79 | 36% |
| Aetna | $99 - $313 | 45% |
| Mass General Brigham [50021] | $127 - $199 | 58% |
| Wellpoint [50012] | $130 - $203 | 59% |
| Multiplan [50010] | $136 - $213 | 62% |
| Altus Dental [99011] | $200 - $313 | 91% |
| Beacon Health Strategies [50002] | $200 - $313 | 91% |
| Blue Cross Blue Shield | $200 - $589 | 91% |
| Cbhc Uninsured Crisis Alt Payer [70097] | $200 - $313 | 91% |
| Cbhc Uninsured Crisis [70096] | $200 - $313 | 91% |
| Celticare [50004] | $200 - $313 | 91% |
| Cigna | $200 - $1,615 | 91% |
| Commonwealth Care Alliance Dental [99004] | $200 - $313 | 91% |
| Coverage Discovery [90004] | $200 - $313 | 91% |
| Delta Dental Of Ma [99007] | $200 - $313 | 91% |
| Dominion National Dental [99012] | $200 - $313 | 91% |
| Dph Tb Payor [85004] | $200 - $313 | 91% |
| Esp Dental [99003] | $200 - $313 | 91% |
| Eyemed Alt Payor [13001] | $200 - $313 | 91% |
| First Health [50007] | $200 - $313 | 91% |
| Global Medical Management [50024] | $200 - $313 | 91% |
| Government Employee Health Association [50023] | $200 - $313 | 91% |
| Guardian Dental [99013] | $200 - $313 | 91% |
| Health Safety Net Dental [99002] | $200 - $313 | 91% |
| Humana | $200 - $313 | 91% |
| Ma Laborers Health And Welfare Fund [50022] | $200 - $313 | 91% |
| Magellan Health Services [65098] | $200 - $313 | 91% |
| Mass Health Dental [99001] | $200 - $313 | 91% |
| Medical Mutual Of Ohio [50019] | $200 - $313 | 91% |
| Medicare (plans) | $200 - $313 | 91% |
| Metlife Dental [99008] | $200 - $313 | 91% |
| Modern Assistance Program [30098] | $200 - $313 | 91% |
| Mva [90002] | $200 - $313 | 91% |
| Neighborhood Health Plan [50011] | $200 - $313 | 91% |
| Other Bh Payor [50014] | $200 - $313 | 91% |
| Other Commercial Payor [50015] | $200 - $313 | 91% |
| Other Dental Payor [99014] | $200 - $313 | 91% |
| Other Dual Eligible Payer [65004] | $200 - $313 | 91% |
| Other Gov'T Alt [85006] | $200 - $313 | 91% |
| Other Vision Payor [50013] | $200 - $313 | 91% |
| Ri Neighborhood Health Plan [50017] | $200 - $313 | 91% |
| Tricare | $200 - $313 | 91% |
| Aarp [40001] | $203 | 92% |
| Oxford Health [40004] | $203 | 92% |
| United Medical Resource [40005] | $203 | 92% |
| UnitedHealthcare | $203 - $727 | 92% |
| Other Tufts Health Public Plan [75002] | $554 | 251% |
| Tufts Health Plan [30001] | $630 - $802 | 286% |
| Health Plans Inc [20002] | $727 | 330% |
| Hphc [20001] | $727 | 330% |