CMS Price Transparency Data

Neurobehavioral status check

Facility: Garden City Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $214
  • Cash Discount Price: $214
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Garden City Hospital is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $214. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.97x the Medicare baseline. Located in 6245 Inkster Rd, Garden City, MI.
Cash / Self-Pay
$214

Average discount available for prompt cash payment at this facility.

Insurance Median
$214

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: $214 (97%)
Insurance Median: $214 (97%)
Cash: $214 (97% of Medicare)
Ins. Median: $214 (97% 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
UnitedHealthcare $83 38%
Beacon Health Strategies $95 - $115 43%
Aetna $115 - $214 52%
Harbor Health Plan $115 - $214 52%
Mclaren Health Plan $115 - $214 52%
Medicaid / KanCare $115 - $126 52%
Priority Health $115 52%
Total Health Care Priority Health $115 - $214 52%
Blue Cross Blue Shield $214 97%
Honest Hmo $214 97%
Humana $214 97%
Medicare (plans) $214 97%
Sunrise $214 97%
Tricare $214 97%
Zing $225 102%
Longevity Hp $227 103%
Employer Direct Healthcare $300 136%
Naphcare Residential Inmate Treatment Center $332 150%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6245 Inkster Rd, Garden City, MI 48135
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals