CMS Price Transparency Data

Neurobehavioral status check

Facility: Sunrise Hospital and Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $102
  • Cash Discount Price: $321
  • vs. Medicare Baseline: 0.46x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Sunrise Hospital and Medical Center is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $321. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.46x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.
Cash / Self-Pay
$321

Average discount available for prompt cash payment at this facility.

Insurance Median
$102

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: $321 (146%)
Insurance Median: $102 (46%)
Cash: $321 (146% of Medicare)
Ins. Median: $102 (46% 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
Humana $56 - $93 25%
Amerigroup $61 - $82 28%
Health Plan Nevada $61 - $86 28%
Molina $64 - $91 29%
Silver Summit $64 - $110 29%
Healthcare Partners Of Nv $74 - $119 34%
Aetna $76 - $127 34%
Alignment Health Plan $76 - $88 34%
Blue Cross Blue Shield $76 - $183 34%
United $78 - $192 35%
Caremore $80 - $93 36%
Hometown Health Providers $87 - $160 39%
Culinary Health Fund $100 - $163 45%
Sierra $100 - $124 45%
Cigna $101 - $201 46%
Multiplan $102 - $119 46%
Select Health $153 - $210 69%
Legacy Provider Network $317 144%
Corvel $334 - $354 151%
Comp-Med Workers Comp $341 155%
Olympus Medsave Usa $352 - $373 160%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3186 S Maryland Pkwy, Las Vegas, NV 89109
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals