CMS Price Transparency Data

Neurobehavioral status check

Facility: NYU Langone Hospitals

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $448
Cash Discount Price: $142
vs. Medicare Baseline: 2.03x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at NYU Langone Hospitals is $448. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 2.03x the Medicare baseline. Located in 550 First Avenue, New York, NY.

Cash / Self-Pay

$142

Average discount available for prompt cash payment at this facility.

Insurance Median

$448

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: $142 (64%)

Insurance Median: $448 (203%)

Cash: $142 (64% of Medicare)

Ins. Median: $448 (203% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 203% of the Medicare baseline (a markup of 103%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Fidelis	$77 - $752	35%
Healthfirst	$77 - $752	35%
Healthplus	$77 - $752	35%
Amida	$85	39%
1199	$97	44%
Hip	$290 - $546	131%
Medicaid / KanCare	$290 - $334	131%
Metroplus	$290 - $752	131%
UnitedHealthcare	$290 - $772	131%
Somos	$305 - $451	138%
Ghi	$368 - $598	167%
Medicare (plans)	$368	167%
Wellcare	$368	167%
Magnacare	$374	170%
Centerlight	$376	170%
Cigna	$430	195%
Aetna	$448 - $747	203%
Hamaspik	$553	251%
Multiplan	$583	264%
Oxford	$687 - $785	311%
Blue Cross Blue Shield	$928 - $1,160	421%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $142.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm NYU Langone Hospitals is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96116.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.