CMS Price Transparency Data

Neurobehavioral status check

Facility: Saratoga Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $93
  • Cash Discount Price: $170
  • vs. Medicare Baseline: 0.42x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Saratoga Hospital is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.42x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.
Cash / Self-Pay
$170

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

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: $170 (77%)
Insurance Median: $93 (42%)
Cash: $170 (77% of Medicare)
Ins. Median: $93 (42% 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
Medicaid / KanCare $46 - $82 21%
Cdphp $51 - $434 23%
Fidelis $56 - $434 25%
Medicare (plans) $56 - $87 25%
Blue Cross Blue Shield $62 - $357 28%
Tricare $64 - $87 29%
Hamaspik $70 - $501 32%
Emblem Health Ghi $75 - $95 34%
UnitedHealthcare $75 - $305 34%
Mvp $76 - $165 34%
Aetna $77 - $100 35%
Blue Shield Highmark $98 - $120 44%
Nascentia Health Options $115 52%
Emblem $118 - $368 53%
Cigna $119 - $165 54%
Mvp Essential Plan $193 - $386 87%
Mvp Govt Programs $193 87%
Empire Plan Nyship $207 - $288 94%
Mvp Commercial $237 - $254 107%
Multiplan $254 - $288 115%
Magnacare $305 - $322 138%
Blue Shield $334 - $348 151%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 211 Church Street, Saratoga Springs, NY 12866
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals