CMS Price Transparency Data

Neurobehavioral status check

Facility: University of Toledo Medical Center

Billing Code: 96116 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$186

about 0.8× the $221 Medicare rate · typically $186–$297

modeled estimate · not a bill or quote

What this hospital charges insurers

$297

Above the fair price

about $111 over the fair price · 1.3× Medicare

Medicare pays $221 Fair price $186 This hospital $297 Cash price $427 Hospital's list price $711

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

Highest price of the 9 OH hospitals we have prices for — worth calling around.

Cheapest $90 Priciest $297

Black dot = this hospital, among the 9 OH hospitals with a price for this procedure. Full list below.

A fair price for a Neurobehavioral status check is about $186 (about 0.8× the $221 Medicare rate). University of Toledo Medical Center charges insurers about $297, or about $427 in cash — above the fair price. Located in Toledo, OH.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $186. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$297 - $1,836	135%
Blue Cross Blue Shieldmajor	$267 - $462	121%
Aetnamajor	$78 - $385	35%
Cignamajor	$346	157%
Humanamajor	$297	135%
CareSource	$297 - $327	135%
Devoted Health	$297	135%
Medical Mutual	$297 - $485	135%
Meridian	$297	135%
Molina	$312 - $327	141%
Paramount	$167 - $327	76%
WellCare	$297	135%
+ 11 smaller / regional plans	$251 - $564

Government programs also on file: Medicare.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 427), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 96116.

Insurance Before you use insurance

Call your insurance company to confirm University of Toledo Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 96116.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at University of Toledo Medical Center

Compare: Neurobehavioral status check at other OH hospitals

Insurance negotiated median for the same procedure, sorted lowest first.