CMS Price Transparency Data

Neurobehavioral status check

Facility: Jfk University Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $409
  • Cash Discount Price: $328
  • vs. Medicare Baseline: 1.85x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Jfk University Medical Center is $409. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $328. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.85x the Medicare baseline. Located in 65 James Street, Edison, NJ.
Cash / Self-Pay
$328

Average discount available for prompt cash payment at this facility.

Insurance Median
$409

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: $328 (149%)
Insurance Median: $409 (185%)
Cash: $328 (149% of Medicare)
Ins. Median: $409 (185% 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
Horizon $49 - $604 22%
Aetna $105 - $583 48%
UnitedHealthcare $112 - $851 51%
Clover $117 53%
Karna $133 60%
Seoul Medical Group $140 63%
Blue Cross Blue Shield $154 - $345 70%
Amerigroup $311 - $345 141%
Vaccn $311 - $345 141%
Wellcare $311 - $345 141%
United Community/Americhoice $327 - $362 148%
Activecare First McO $455 206%
Intergroup $455 206%
Bergen Risk $488 221%
Cigna $520 - $626 236%
Prime Health $520 236%
Multiplan - PHCS $552 250%
Brighton Health Plan $585 265%
Qualcare $602 273%
Amerihealth $615 279%
Oxford $633 - $655 287%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 65 James Street, Edison, NJ 08818
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals