CMS Price Transparency Data

Neurobehavioral status check

Facility: Memorial Health Care Systems

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $149
Cash Discount Price: $256
vs. Medicare Baseline: 0.68x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Memorial Health Care Systems is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $256. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.68x the Medicare baseline. Located in 300 North Columbia Ave, Seward, NE.

Cash / Self-Pay

$256

Average discount available for prompt cash payment at this facility.

Insurance Median

$149

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: $256 (116%)

Insurance Median: $149 (68%)

Cash: $256 (116% of Medicare)

Ins. Median: $149 (68% 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
Molina Mcaid-All Plans	$138	63%
Ne Total Care Mcaid-All Plans	$138	63%
UnitedHealthcare	$138 - $251	63%
Beshp Mcr Adv - All Plans	$146	66%
Blue Cross Blue Shield	$146 - $243	66%
Medica Mcare Cost	$146	66%
Medica Mcr Adv	$146	66%
Tricare	$146	66%
Wellcare Mcr Adv - All Plans	$149	68%
Phcs Ppo-All Plans	$243	110%
Ambetter / Centene	$246	112%
Medica Comm-All Other Plans	$246	112%
Medica Elevate	$246	112%
Midlands Choice-All Plans	$248	112%
Aetna	$251	114%

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 $256.
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 Memorial Health Care Systems 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.