CMS Price Transparency Data

Neurobehavioral status check

Facility: Albany Medical Center Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $107
  • Cash Discount Price: $124
  • vs. Medicare Baseline: 0.49x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Albany Medical Center Hospital is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $124. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.49x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.
Cash / Self-Pay
$124

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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: $124 (56%)
Insurance Median: $107 (49%)
Cash: $124 (56% of Medicare)
Ins. Median: $107 (49% 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
Mvp Commercial $28 - $400 13%
UnitedHealthcare $28 - $427 13%
Emblem $30 - $427 14%
Emblem_Ghi $30 - $427 14%
Empire Plan Nyship $30 - $135 14%
Magnacare $30 - $427 14%
Multiplan $32 - $454 15%
Blue Shield $38 - $215 17%
Medicaid / KanCare $46 - $82 21%
Cdphp $51 - $428 23%
Carelon Beacon Behavioral $53 24%
Medicare (plans) $56 - $95 25%
Fidelis $59 - $630 27%
Blue Cross Blue Shield $62 - $428 28%
Tricare $64 - $87 29%
Hamaspik $70 - $501 32%
Blue Shield Highmark $75 - $195 34%
Mvp $76 - $350 34%
Aetna $78 - $182 35%
Emblem Health Ghi $83 - $188 38%
Nascentia $83 - $95 38%
Nascentia Health Options $115 52%
Cigna $119 - $165 54%
Nys Department Of Corrections $188 - $210 85%
Mvp Essential Plan $409 185%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 43 New Scotland Avenue, Mail Code 34, Albany, NY 12208
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals