CMS Price Transparency Data

Neurobehavioral status check

Facility: Atrium Health Pineville

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $216
  • Cash Discount Price: $353
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Atrium Health Pineville is $216. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $353. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.98x the Medicare baseline. Located in 10628 Park Rd, Charlotte, NC.
Cash / Self-Pay
$353

Average discount available for prompt cash payment at this facility.

Insurance Median
$216

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: $353 (160%)
Insurance Median: $216 (98%)
Cash: $353 (160% of Medicare)
Ins. Median: $216 (98% 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
Aetna $59 - $586 27%
Partners $71 - $74 32%
Alliance $72 - $75 33%
Amerihealth Caritas $72 - $74 33%
Carolina Complete Health $73 - $74 33%
Healthy Blue $73 - $74 33%
Trillium $73 - $75 33%
Wellcare $73 - $74 33%
UnitedHealthcare $74 - $333 34%
Vaya $74 34%
Cigna $75 - $477 34%
Humana $76 - $302 34%
Physician Reach Out $76 - $353 34%
Blue Cross Blue Shield $92 - $275 42%
Ortho Carolina $93 - $370 42%
Employers Health Network $107 - $312 49%
Ambetter / Centene $113 - $256 51%
Gmmi $115 - $459 52%
Quik Trip $115 - $459 52%
Healthgram $116 - $565 53%
Multiplan $122 - $650 55%
Private Health Care Systems $125 - $579 57%
First Health $127 - $586 58%
Beechstreet $138 - $635 63%
Provider Select $138 - $635 63%
Choicecare $177 - $522 80%
Medcost $218 - $422 99%
Magellan $424 192%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10628 Park Rd, Charlotte, NC 28210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals