CMS Price Transparency Data

Neurobehavioral status check

Facility: East Liverpool City Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $243
  • Cash Discount Price: $203
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at East Liverpool City Hospital is $243. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $203. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.10x the Medicare baseline. Located in 425 West 5Th Street, East Liverpool, OH.
Cash / Self-Pay
$203

Average discount available for prompt cash payment at this facility.

Insurance Median
$243

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: $203 (92%)
Insurance Median: $243 (110%)
Cash: $203 (92% of Medicare)
Ins. Median: $243 (110% 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
UnitedHealthcare $199 - $255 90%
Blue Cross Blue Shield $203 - $250 92%
Buckeye Community Health Plan $203 - $325 92%
Health America $203 92%
Medical Mutual Of Oh $203 92%
Medicare (plans) $203 92%
Molina $203 - $295 92%
Tricare $203 92%
Care Source $209 - $295 95%
Devoted Health $213 97%
Communicare $218 99%
Valor Health Plan $218 99%
Perennial $224 102%
Medicaid / KanCare $243 110%
Standard Eapg Logic $243 110%
Naphcare $244 111%
Paramount $250 113%
Amerihealth Caritas $255 116%
Employer Direct Healthcare $285 129%
Three Rivers $295 134%
Provider Select $301 136%
Multiplan (Fka Private Healthcare Systems) $304 138%
Worker Compensation $304 138%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 425 West 5Th Street, East Liverpool, OH 43920
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals