CMS Price Transparency Data

Neurobehavioral status check

Facility: Charlevoix Area Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $75
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.34x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Charlevoix Area Hospital is $75. 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 0.34x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$75

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: $75 (34%)
Ins. Median: $75 (34% 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
Mclaren Health Plan $50 - $152 23%
Meridian $50 - $152 23%
Priority Health $50 - $152 23%
UnitedHealthcare $50 - $152 23%
Blue Cross Blue Shield $51 - $152 23%
Aetna $72 33%
Blue Care Network $72 33%
Hap (Health Alliance Plan) $72 - $324 33%
Medicare (plans) $72 33%
Michigan Amish Medical Board $72 33%
Molina $72 33%
Northern Michigan Mennonite Group $72 33%
Asr Physicians Care Network $108 49%
Cigna $108 49%
Nomi Health $115 52%
Employee Benefits Logistics $122 55%
Provider Network Of America/Hma Group Health $303 137%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 14700 Lakeshore Drive, Charlevoix, MI 49720
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals