CMS Price Transparency Data

Neurobehavioral status check

Facility: Metropolitan Hospital Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $197
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Metropolitan Hospital Center is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.89x the Medicare baseline. Located in 1901 First Avenue, New York, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$197

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%)
Insurance Median: $197 (89%)
Ins. Median: $197 (89% 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
Healthfirst $68 - $435 31%
Carelon $69 - $193 31%
Aetna $74 - $257 34%
Wellcare $92 42%
United Behavioral Health $111 - $213 50%
United $159 - $242 72%
Blue Cross Blue Shield $170 - $435 77%
Metroplus $177 - $435 80%
Oxford $184 83%
Amidacare $193 87%
Fidelis $193 - $523 87%
Senior Whole Health $193 87%
Affinity $197 - $435 89%
Carelon (Amida Care) $197 89%
Vnsny $197 - $368 89%
Emblem $242 - $261 110%
Elderplan $368 167%
Vaccn $368 167%
Centers Plan For Healthy Living $383 174%
Centerlight $412 187%
Oscar $553 251%
Cigna $618 280%
Magnacare $618 280%
Multiplan $659 299%
Local 1199 $700 317%
Villagecare Max $700 317%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 First Avenue, New York, NY 10029
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals