CMS Price Transparency Data

Neurobehavioral status check

Facility: Heywood Hospital -

Billing Code: 96116 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$301

about 1.4× the $221 Medicare rate · typically $106–$396

modeled estimate · not a bill or quote

What this hospital charges insurers

$460

Above the fair price

about $159 over the fair price · 2.1× Medicare

Medicare pays $221 Fair price $301 This hospital $460

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

Highest price of the 9 MA hospitals we have prices for — worth calling around.

Cheapest $211 Priciest $460

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

A fair price for a Neurobehavioral status check is about $301 (about 1.4× the $221 Medicare rate). Heywood Hospital - charges insurers about $460 — above the fair price. Located in Gardner, MA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $301. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser 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	$241	109%
Blue Cross Blue Shieldmajor	$454 - $466	206%
Aetnamajor	$343	155%
Harvard Pilgrim	$628	285%
Tufts Health Plan	$531 - $541	241%
+ 2 smaller / regional plans	$343 - $514

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, 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 Heywood 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 Heywood Hospital -

Compare: Neurobehavioral status check at other MA hospitals

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