CMS Price Transparency Data

Neurobehavioral status check

Facility: New Ulm Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $223
Cash Discount Price: $209
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at New Ulm Medical Center is $223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $209. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.01x the Medicare baseline. Located in 1324 Fifth North Street, New Ulm, MN.

Cash / Self-Pay

$209

Average discount available for prompt cash payment at this facility.

Insurance Median

$223

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: $209 (95%)

Insurance Median: $223 (101%)

Cash: $209 (95% of Medicare)

Ins. Median: $223 (101% 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
Ucare Pmap (A B C D E G N O S U R H)	$33 - $142	15%
Aetna	$57 - $386	26%
Medica Dual Solutions (A U)	$72 - $314	33%
Blue Cross Blue Shield	$80 - $415	36%
Americas Ppo (Araz)(A M U)	$109 - $473	49%
Medica Ubh (A)	$114 - $495	52%
First Health (A C E G H U B D N O R S)	$137 - $594	62%
Medicaid / KanCare	$206	93%
Medicare (plans)	$223	101%
Medica	$234	106%
Hennepin Health	$235	107%
Health Partners	$284 - $715	129%
UnitedHealthcare	$612	277%
Cigna	$780	354%

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 $209.
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 New Ulm Medical Center 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.