CMS Price Transparency Data

Neurobehavioral status check

Facility: Metrohealth System

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $306
  • Cash Discount Price: $390
  • vs. Medicare Baseline: 1.39x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Metrohealth System is $306. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $390. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.39x the Medicare baseline. Located in 2500 Metrohealth Drive, Cleveland, OH.
Cash / Self-Pay
$390

Average discount available for prompt cash payment at this facility.

Insurance Median
$306

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: $390 (177%)
Insurance Median: $306 (139%)
Cash: $390 (177% of Medicare)
Ins. Median: $306 (139% 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 $111 - $812 50%
Aarp $204 92%
Valor Health $206 93%
Perennial Advantage $208 94%
Mcgregor Pace $225 102%
Buckeye Health Plan $266 121%
Caresource $286 130%
Aetna $327 148%
Health E Ohio $429 194%
Blue Cross Blue Shield $444 - $779 201%
Clarity Health $531 241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2500 Metrohealth Drive, Cleveland, OH 44109
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals