CMS Price Transparency Data

Neurobehavioral status check

Facility: Parkland Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $1,034
Cash Discount Price: $1,951
vs. Medicare Baseline: 4.69x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Parkland Medical Center is $1,034. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,951. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 4.69x the Medicare baseline. Located in 1 Parkland Drive, Derry, NH.

Cash / Self-Pay

$1,951

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,034

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: $1,951 (884%)

Insurance Median: $1,034 (469%)

Cash: $1,951 (884% of Medicare)

Ins. Median: $1,034 (469% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 469% of the Medicare baseline (a markup of 369%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Amerihealth Caritas	$60	27%
Well Sense Health Plan	$146	66%
Harvard Pilgrim	$374 - $878	170%
United	$410 - $1,184	186%
Maine Community Health	$610 - $1,034	277%
Cigna	$710 - $821	322%
Blue Cross Blue Shield	$852	386%
Tufts Health Plan	$1,116 - $1,149	506%
Aetna	$1,161 - $1,303	526%
Mvp Health Plan	$1,366	619%
Corvel	$1,405	637%
Evernorth	$1,561	708%
Healthcare Value Mgmt	$1,639	743%
First Health	$1,658	752%
Oxford Health Plans	$1,853	840%

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 $1,951.
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 Parkland 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.