CMS Price Transparency Data

Neurobehavioral status check

Facility: Westfield Memorial Hospital Inc

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $100
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 0.45x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Westfield Memorial Hospital Inc is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.45x the Medicare baseline. Located in 189 E Main St, Westfield, NY.
Cash / Self-Pay
$49

Average discount available for prompt cash payment at this facility.

Insurance Median
$100

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: $49 (22%)
Insurance Median: $100 (45%)
Cash: $49 (22% of Medicare)
Ins. Median: $100 (45% 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
Community Care Behavorial Health Healthchoices $60 27%
Community Care Behavorial Health University Of Pittsburgh Medical Center $60 27%
Univera $66 - $97 30%
Highmark $69 - $611 31%
Amerihealth $72 - $387 33%
Life Pittsburgh $74 - $368 34%
Carelon $75 34%
Medicare (plans) $79 - $380 36%
American Health Plans $82 - $368 37%
Pennsylvania Health And Wellness $91 41%
Geisinger $100 45%
UnitedHealthcare $100 - $398 45%
Cigna $128 58%
Martin'S Point $232 - $368 105%
Aetna $383 - $708 174%
Humana $391 177%
Molina $402 182%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 189 E Main St, Westfield, NY 14787
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - RURAL EMERGENCY HOSPITAL (REH)