CMS Price Transparency Data

Neurobehavioral status check

Facility: Wyandotte Hospital and Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $87
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.39x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Wyandotte Hospital and Medical Center is $87. 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 0.39x the Medicare baseline. Located in 2333 Biddle Ave, Wyandotte, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$87

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: $87 (39%)
Ins. Median: $87 (39% 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
Aetna $42 - $336 19%
Hap $42 - $305 19%
Mclaren $42 19%
Meridian Health Plan Of Mi $42 - $385 19%
Priority Health $42 - $521 19%
Amerihealth Michigan $50 - $299 23%
Hap Caresource $50 - $305 23%
Mclaren Health Plan Inc. $50 - $90 23%
Meridian $50 - $90 23%
Molina $52 - $412 24%
Priority $53 - $90 24%
Humana $65 - $311 29%
Beacon Health $73 33%
Pace Se Mi $74 - $86 34%
Bcn $78 - $305 35%
Blue Cross Blue Shield $78 - $305 35%
Cca Health Mi $78 - $90 35%
Health Alliance Plan Of Michigan $78 - $90 35%
Mount Carmel Health Plan $78 - $305 35%
United Behavioral Health, Inc. $78 - $90 35%
UnitedHealthcare $78 - $305 35%
Wellcare Ma $78 35%
Vaccn $87 - $102 39%
Cofinity $88 - $102 40%
Vitalcore Physicians Group Of Mi $101 - $702 46%
Cigna $136 62%
Cofinity Group Health $171 78%
Pace Of Se Mi $290 131%
Cca Health Michigan $305 138%
Erickson $305 138%
Mclaren Health $305 138%
Molina Mi Health Link $305 138%
Wellcare $308 140%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2333 Biddle Ave, Wyandotte, MI 48192
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals