CMS Price Transparency Data

Neurobehavioral status check

Facility: Jamaica Hospital Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $274
  • Cash Discount Price: $591
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Jamaica Hospital Medical Center is $274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $591. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.24x the Medicare baseline. Located in 89Th Avenue and Van Wyck Expressway, Jamaica, NY.
Cash / Self-Pay
$591

Average discount available for prompt cash payment at this facility.

Insurance Median
$274

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: $591 (268%)
Insurance Median: $274 (124%)
Cash: $591 (268% of Medicare)
Ins. Median: $274 (124% 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
UnitedHealthcare $65 - $268 29%
Ghi $70 32%
1999 National Benefit Fund $97 44%
United Behavioral Health $112 - $127 51%
World Trade Center Program $134 61%
Healthfirst $228 103%
Fidelis $255 - $268 116%
Aetna $268 121%
Beacon Health Strategies $268 121%
Centerlight Healthcare $268 121%
Empire $268 - $372 121%
Metroplus $268 - $295 121%
Elderplan $274 124%
Vns $274 124%
Wellcare Of Ny $279 126%
Humana $284 129%
Senior Whole Health $284 129%
Hamaspik Choice $308 140%
Magnacare $308 - $500 140%
Empire Blue Priority $316 143%
Centers Plan For Healthy Living $335 152%
Create Health Plan $371 168%
Emblemhealth $443 201%
Centivo $456 207%
Hotel Trades Council $1,912 867%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 89Th Avenue and Van Wyck Expressway, Jamaica, NY 11418
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals