CMS Price Transparency Data

Neurobehavioral status check

Facility: Queens Hospital Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $188
  • Cash Discount Price: $363
  • vs. Medicare Baseline: 0.85x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Queens Hospital Center is $188. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $363. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.85x the Medicare baseline. Located in 82-68 164Th Street, Jamaica, NY.
Cash / Self-Pay
$363

Average discount available for prompt cash payment at this facility.

Insurance Median
$188

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: $363 (165%)
Insurance Median: $188 (85%)
Cash: $363 (165% of Medicare)
Ins. Median: $188 (85% 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 $42 - $472 19%
United $59 - $63 27%
Carelon $69 - $210 31%
Affinity $74 - $472 34%
Aetna $79 - $368 36%
Emblem $80 - $553 36%
Amidacare $84 38%
Blue Cross Blue Shield $84 - $472 38%
Centerlight $84 38%
Elderplan $84 - $737 38%
Fidelis $84 - $523 38%
Wellcare $85 - $91 39%
Centers Plan For Healthy Living $87 - $383 39%
Hamaspik $88 40%
Local 1199 $97 - $182 44%
Oscar $105 - $553 48%
United Behavioral Health $111 - $231 50%
Metroplus $126 - $210 57%
Senior Whole Health $210 95%
Carelon (Amida Care) $214 97%
Vnsny $214 - $368 97%
Vaccn $368 167%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 82-68 164Th Street, Jamaica, NY 11432
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals