CMS Price Transparency Data

Neurobehavioral status check

Facility: Emerson Hospital -

Billing Code: 96116 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$317

about 1.4× the $221 Medicare rate · typically $110–$438

modeled estimate · not a bill or quote

What this hospital charges insurers

$255

Below the fair price — a good deal

about $62 under the fair price · 1.2× Medicare

Medicare pays $221 Fair price $317 This hospital $255 Cash price $911 Hospital's list price $1,214

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

One of the lower prices — 6 of 8 other MA hospitals charge more for the same procedure.

Cheapest $211 Priciest $382

Black dot = this hospital, among the 9 MA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Neurobehavioral status check is about $317 (about 1.4× the $221 Medicare rate). Emerson Hospital - charges insurers about $255, or about $911 in cash — below the fair price — a good deal. Located in W Concord, MA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$255 - $1,214	116%
Blue Cross Blue Shieldmajor	$255 - $910	116%
Aetnamajor	$777	352%
Cignamajor	$1,111	504%
Tufts Health Plan	$254	115%
+ 1 smaller / regional plan	$303

Government programs also on file: Medicare, Medicaid.

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 911), 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 Emerson Hospital - 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 Emerson Hospital -

Compare: Neurobehavioral status check at other MA hospitals

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