CMS Price Transparency Data

Neurobehavioral status check

Facility: North Carolina Baptist Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $205
  • Cash Discount Price: $283
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at North Carolina Baptist Hospital is $205. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $283. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.93x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$283

Average discount available for prompt cash payment at this facility.

Insurance Median
$205

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: $283 (128%)
Insurance Median: $205 (93%)
Cash: $283 (128% of Medicare)
Ins. Median: $205 (93% 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
Medcost $112 - $376 51%
Blue Cross Blue Shield $117 - $301 53%
Amerihealth $128 - $153 58%
Carolina Complete $128 58%
Health Blue $128 58%
Partners $128 58%
Vaya $129 58%
Alliance $130 59%
UnitedHealthcare $130 - $301 59%
Wellcare $130 - $301 59%
Trillium $132 60%
Aetna $134 - $481 61%
Ambetter / Centene $153 69%
Oscar $170 - $204 77%
Cigna $173 - $340 78%
Apex $301 136%
Devoted $301 136%
Healthteam $301 136%
Humana $304 - $310 138%
Medicare (plans) $304 138%
Directnet $335 152%
Liberty $347 157%
Cone Health $396 180%
Healthgram $396 180%
First Carolina Care $453 205%
Private Healthcare Systems $464 210%
Multiplan $509 231%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals