CMS Price Transparency Data

Neurobehavioral status check

Facility: Boston Children's Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $388
  • Cash Discount Price: $517
  • vs. Medicare Baseline: 1.76x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Boston Children's Hospital is $388. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $517. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.76x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.
Cash / Self-Pay
$517

Average discount available for prompt cash payment at this facility.

Insurance Median
$388

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: $517 (234%)
Insurance Median: $388 (176%)
Cash: $517 (234% of Medicare)
Ins. Median: $388 (176% 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.

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
Cdphp $253 - $439 115%
Harvard Pilgrim $263 - $349 119%
Blue Cross Blue Shield $292 - $609 132%
United $309 - $432 140%
Aetna $310 - $433 141%
Mgb/Allways $314 - $382 142%
Tufts Public Plan $318 144%
United Ri Nj Ny $326 148%
Ambetter / Centene $327 148%
Carelon Strategies/Bhs $336 152%
UnitedHealthcare $336 - $439 152%
Carelon/Beacon $388 176%
Fallon $394 - $399 179%
Health New England $418 189%
Cigna $439 - $517 199%
Ets/Lifetrac $439 199%
Interlink Transplant $439 199%
Community Health Options $465 211%
Humana $465 211%
Coventry/Hcvm/First Health $476 216%
Multiplan/Phcs $476 - $491 216%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Longwood Avenue, Boston, MA 02115
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens