CMS Price Transparency Data

Neurobehavioral status check

Facility: Ocean Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $416
  • Cash Discount Price: $326
  • vs. Medicare Baseline: 1.89x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Ocean Medical Center is $416. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $326. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.89x the Medicare baseline. Located in 425 Jack Martin Blvd, Brick, NJ.
Cash / Self-Pay
$326

Average discount available for prompt cash payment at this facility.

Insurance Median
$416

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: $326 (148%)
Insurance Median: $416 (189%)
Cash: $326 (148% of Medicare)
Ins. Median: $416 (189% 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 $92 - $585 42%
Clover $117 53%
Seoul Medical Group $126 - $140 57%
Karna $130 - $133 59%
Blue Cross Blue Shield $154 - $340 70%
Horizon $249 - $537 113%
Amerigroup $311 141%
Vaccn $311 - $340 141%
Wellcare $311 - $340 141%
United Community/Americhoice $327 - $357 148%
Qualcare $359 - $572 163%
UnitedHealthcare $383 - $851 174%
Oxford $393 - $633 178%
Activecare First McO $455 - $552 206%
Intergroup $455 206%
Bergen Risk $488 221%
Cigna $520 - $626 236%
Prime Health $520 236%
Multiplan - PHCS $552 250%
Amerihealth $558 - $633 253%
Brighton Health Plan $585 265%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 425 Jack Martin Blvd, Brick, NJ 08724
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals