CMS Price Transparency Data

Neurobehavioral status check

Facility: University Hospitals Samaritan Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $366
  • Cash Discount Price: $323
  • vs. Medicare Baseline: 1.66x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at University Hospitals Samaritan Medical Center is $366. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $323. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.66x the Medicare baseline. Located in 1025 Center St, Ashland, OH.
Cash / Self-Pay
$323

Average discount available for prompt cash payment at this facility.

Insurance Median
$366

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: $323 (146%)
Insurance Median: $366 (166%)
Cash: $323 (146% of Medicare)
Ins. Median: $366 (166% 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
Medical Mutual Of Ohio $153 - $427 69%
University Health Employee Plan (Contigo) $172 78%
Amish Aid Community Plan $198 90%
Amish Church Fund And Workers Aid Plan $198 90%
Buckeye Plain Ministries $198 90%
Christian Healthcare Ministries $216 98%
Immergrun $216 98%
Sunrise Plain Communities $216 98%
Cigna $241 - $397 109%
Aetna $271 - $483 123%
Blue Cross Blue Shield $271 - $389 123%
Devoted Health $271 123%
Humana $271 123%
Molina $271 123%
Primetime Health Plan $271 123%
Summacare $271 - $392 123%
The Health Plan $271 - $379 123%
UnitedHealthcare $271 - $397 123%
Wellcare By Allwell $271 123%
Paramount $280 127%
Perennial Advantage Of Ohio $285 129%
Valor Health Plans $285 129%
Medical Mutual Traditional/Health Ohio $302 137%
Beech Street $345 - $388 156%
Ohio Preferred Network $345 - $388 156%
First Health $358 162%
Century Health Network $366 166%
Ohio Health Choice $366 - $388 166%
Private Healthcare System $371 168%
Aultcare $388 176%
Clarity $388 176%
Configurenet $388 176%
Fortified Provider Network $388 176%
Healthsmart $388 176%
Jp Farley $388 176%
Multiplan $388 176%
Ambetter / Centene $489 222%
Caresource $489 222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1025 Center St, Ashland, OH 44805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals