CMS Price Transparency Data

Neurobehavioral status check

Facility: Ascension Providence Hospital, Southfield and Novi

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $305
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.38x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Ascension Providence Hospital, Southfield and Novi is $305. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.38x the Medicare baseline. Located in 16001 W Nine Mile Rd, Southfield, MI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$305

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%)

Insurance Median: $305 (138%)

Ins. Median: $305 (138% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Hap Alliance Health	$101	46%
Hap Hmo Pos	$101	46%
Molina Health	$116 - $177	53%
Hap Preferred	$119	54%
Blue Caid Michigan	$177	80%
Harbor Health Mcd	$177	80%
Medicaid / KanCare	$177 - $305	80%
Total Health Care	$177	80%
UnitedHealthcare	$177	80%
Amerihealth Vip Care Mcr	$262 - $302	119%
Aetna	$305	138%
Auto Insurance	$305	138%
Jvhl - Mcr Replacement	$305	138%
Mcr Replacement	$305	138%
Veterans Choice	$305	138%
Humana	$308	140%
Meridian Wellcare	$320	145%
Molina Advantage	$320	145%
Ambetter / Centene	$381	173%
Molina Marketplace	$381	173%
Smart Health	$421	191%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ascension Providence Hospital, Southfield and Novi is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96116.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.