CMS Price Transparency Data

Neurobehavioral status check

Facility: Coshocton Regional Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $241
Cash Discount Price: $203
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Coshocton Regional Medical Center is $241. 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 1.09x the Medicare baseline. Located in 1460 Orange Street, Coshocton, OH.

Cash / Self-Pay

$203

Average discount available for prompt cash payment at this facility.

Insurance Median

$241

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: $241 (109%)

Cash: $203 (92% of Medicare)

Ins. Median: $241 (109% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$203 - $245	92%
Care Source	$203 - $295	92%
Medicare (plans)	$203	92%
Molina	$203 - $295	92%
The Health Plan	$203	92%
Tricare	$203	92%
UnitedHealthcare	$203 - $250	92%
Med Mutual Of Oh	$207	94%
Buckeye Community Health Plan	$213 - $254	97%
Devoted Health	$213	97%
Valor Health Plan	$218	99%
Perennial Advantage	$224	102%
Medicaid / KanCare	$238	108%
Standard Eapg Logic	$238	108%
Amerihealth Caritas	$250	113%
Paramount	$250	113%
Quality Care Partner	$250	113%
Employer Direct Healthcare	$285	129%
Americas Choice Provider Network	$304	138%
Corvel	$304	138%
Healthsmart	$304	138%
Multiplan	$304	138%
Provider Network Of America	$304	138%
Provider Select	$304	138%
Three Rivers	$304	138%
Workers Compensation	$304	138%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $203.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Coshocton Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96116.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.