CMS Price Transparency Data

Neurobehavioral status check

Facility: Buffalo Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $425
  • Cash Discount Price: $507
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Buffalo Hospital is $425. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $507. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.93x the Medicare baseline. Located in 303 Catlin Street, Buffalo, MN.
Cash / Self-Pay
$507

Average discount available for prompt cash payment at this facility.

Insurance Median
$425

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: $507 (230%)
Insurance Median: $425 (193%)
Cash: $507 (230% of Medicare)
Ins. Median: $425 (193% 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
Blue Cross Blue Shield $114 - $353 52%
Ucare Pmap (A B C D E G N O S U R H) $182 83%
Medicaid / KanCare $206 93%
Aetna $211 - $538 96%
South Country Health Alliance $212 96%
Medicare (plans) $223 101%
Medica $231 105%
Medica Health System $461 - $729 209%
Healthpartners $613 278%
Health Partners $668 - $780 303%
UnitedHealthcare $674 306%
Americas Ppo (Araz)(B D N O R S V) $698 316%
Medica Ub Health (B) $722 327%
Americas Ppo (Araz) (B D N H O R S) $760 345%
First Health (A C E G H U B D N O R S) $760 345%
All Other Contracted Care (A B C D E G H N O R S U) $905 410%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 Catlin Street, Buffalo, MN 55313
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals