CMS Price Transparency Data

Neurobehavioral status check

Facility: Mainehealth Pen Bay Hospital

Billing Code: 96116 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$170
about 0.8× the $221 Medicare rate · typically $97–$268
modeled estimate · not a bill or quote
What this hospital charges insurers
$159
About the fair price
about $11 under the fair price · 0.7× Medicare
Medicare pays $221 Fair price $170 This hospital $159

How we calculate the fair BaseRate →

How this hospital compares to other ME hospitals

A typical price — 1 charge more and 2 charge less, among the 6 ME hospitals compared.

Cheapest $153 Priciest $160

Black dot = this hospital, among the 6 ME hospitals with a price for this procedure. Full list below.

A fair price for a Neurobehavioral status check is about $170 (about 0.8× the $221 Medicare rate). Mainehealth Pen Bay Hospital charges insurers about $159 — about the fair price. Located in Rockport, ME.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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 $87 - $301 39%
Blue Cross Blue Shieldmajor $76 - $1,464 34%
Aetnamajor $77 - $307 35%
Cignamajor $167 76%
Humanamajor $87 - $301 39%
Harvard Pilgrim $177 80%
WellCare $78 - $310 35%
+ 1 smaller / regional plan $160 - $241
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 6 Glen Cove Drive, Rockport, ME 04856
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals