CMS Price Transparency Data

Neurobehavioral status check

Facility: University Medical Center of Princeton at Plainsboro

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $236
  • Cash Discount Price: $278
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at University Medical Center of Princeton at Plainsboro is $236. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $278. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.07x the Medicare baseline. Located in One-Five Plainsboro Road, Plainsboro, NJ.
Cash / Self-Pay
$278

Average discount available for prompt cash payment at this facility.

Insurance Median
$236

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: $278 (126%)
Insurance Median: $236 (107%)
Cash: $278 (126% of Medicare)
Ins. Median: $236 (107% 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 $26 - $394 12%
Charity Care $26 12%
Medicaid / KanCare $26 - $278 12%
Wellcare $28 13%
Blue Cross Blue Shield $56 - $246 25%
Horizon Nj Health $60 27%
Preferred Health Care Eliance $72 33%
UnitedHealthcare $88 - $246 40%
Cigna $104 - $278 47%
Horizon Behavioral Health $104 47%
Beacon Health Options $139 63%
Amerihealth $165 75%
Princeton Theological Seminary $181 82%
Coventry $195 88%
Health Net $195 88%
Magnacare $195 - $299 88%
Beech Street $222 - $236 101%
Intergrated Health Plan $222 101%
Intergroup $222 101%
Penn Global Medicine Embassy Only $222 101%
Allied Trades $236 107%
Consumer Health Network $236 107%
Devon Health Services $236 107%
First Managed Care Option $236 - $308 107%
Ie Shaffer $236 107%
Private Healthcare Systems $236 107%
Qualcare $236 107%
Total Care Network $236 107%
Tri-State $236 107%
Tricare $243 110%
Medicare (plans) $246 - $271 112%
Va Medical Center $246 112%
Clover Health Plan $261 118%
Humana $266 121%
Commercial Other $278 126%
Compsych $278 126%
Concern Plus $278 126%
International Pfs $278 126%
Life St. Francis $278 126%
Magellan $278 126%
Managed Health Network $278 126%
Nj Carpenters $278 126%
Penn Behavioral Health Corporate Services $278 126%
Personnel Health Program $278 126%
United Behavioral Health $278 126%
Us Family Health Plan $279 126%
Elap $350 - $443 159%
Centivo $443 201%
Claim Watcher $443 201%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One-Five Plainsboro Road, Plainsboro, NJ 08536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals