CMS Price Transparency Data
Neurobehavioral status check
Facility: St Charles Hospital
Billing Code: 96116 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 96116
- Insurance Median: $369
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.67x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at St Charles Hospital is $369. 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 1.67x the Medicare baseline. Located in 200 Belle Terre Road, Port Jefferson, NY.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$369
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: $369 (167%)
Ins. Median: $369 (167% 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 |
|---|---|---|
| Affinity Health Plan | $59 - $134 | 27% |
| Beacon Health Options | $59 - $516 | 27% |
| Beacon Health Strategies | $59 - $516 | 27% |
| Centerlight Healthcare | $59 - $368 | 27% |
| Elderplan Inc. | $59 - $368 | 27% |
| Emblem Health | $59 - $829 | 27% |
| Fidelis Care New York | $59 - $368 | 27% |
| Health First | $59 - $829 | 27% |
| Health Plus | $59 - $368 | 27% |
| Independent Health | $59 - $368 | 27% |
| Medicaid / KanCare | $59 | 27% |
| Mvp Health Plans | $59 - $858 | 27% |
| Senior Whole Health | $59 - $368 | 27% |
| UnitedHealthcare | $59 - $514 | 27% |
| Self Pay | $130 | 59% |
| Zadroga | $133 | 60% |
| Blue Cross Blue Shield | $227 - $368 | 103% |
| Aetna | $368 - $858 | 167% |
| Centers Plan For Healthy Living | $368 | 167% |
| Healthspring | $368 | 167% |
| Liberty Health | $368 | 167% |
| Longevity Health Plan | $368 | 167% |
| Medicare (plans) | $368 - $387 | 167% |
| Orthonet - Uniformed Services Family Health Plan | $368 | 167% |
| Pmc | $368 | 167% |
| Tricare | $368 | 167% |
| Universal Healthcare | $368 | 167% |
| Us Family Health Plan | $368 | 167% |
| Veterans Affairs | $368 | 167% |
| Humana | $376 | 170% |
| Agewell New York | $381 | 173% |
| Partners Health Plan | $387 | 175% |
| Local 1199 | $388 | 176% |
| Wellcare Health Plan Inc | $405 | 184% |
| Surest | $514 | 233% |
| Oscar Health | $703 | 319% |
| American Plan Administrators | $829 | 376% |
| Amerihealth Administrators | $829 | 376% |
| Benefit Services | $829 | 376% |
| Ghi Cbp Ny City Employee Alternate | $829 | 376% |
| International Benefit Administrator | $829 | 376% |
| Ultra Benefits Inc. | $829 | 376% |
| Apwu | $858 | 389% |
| Brighton | $858 - $1,200 | 389% |
| Centivo | $858 | 389% |
| Cigna | $858 - $1,115 | 389% |
| Daniel H Cook | $858 | 389% |
| Mail Handlers Benefit Plan | $858 | 389% |
| Meritain Health | $858 | 389% |
| Nalc | $858 | 389% |
| Nippon Life Insurance Company Of America | $858 | 389% |
| Salvation Army | $858 | 389% |
| Samba | $858 | 389% |
| Allied Wellfare Fund | $1,115 | 505% |
| American Group Administrators | $1,115 | 505% |
| Bakery & Confectionery Union | $1,115 | 505% |
| Comprehensive Benefits Consultant | $1,115 | 505% |
| Guardian Life Insurance Company Of America | $1,115 | 505% |
| Maloney And Assoc | $1,115 | 505% |
| Multiplan | $1,115 | 505% |
| Performax | $1,115 | 505% |
| Phcs | $1,115 | 505% |
| Pomco | $1,115 | 505% |
| Tpa Inc | $1,115 | 505% |
| Unicare | $1,115 | 505% |
| United Employees Health Plan | $1,115 | 505% |
| Coventry | $1,269 - $1,458 | 575% |
| Magellan | $1,372 | 622% |
| Galaxy | $1,544 | 700% |
| Three Rivers Provider Network | $1,544 | 700% |
| Aither Health | $1,715 | 777% |
| Alpha Care | $1,715 | 777% |
| Dentaquest | $1,715 | 777% |