CMS Price Transparency Data

Neurobehavioral status check

Facility: Memorial Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $322
  • Cash Discount Price: $625
  • vs. Medicare Baseline: 1.46x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Memorial Hospital is $322. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $625. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.46x the Medicare baseline. Located in 715 South Taft Avenue, Fremont, OH.
Cash / Self-Pay
$625

Average discount available for prompt cash payment at this facility.

Insurance Median
$322

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: $625 (283%)
Insurance Median: $322 (146%)
Cash: $625 (283% of Medicare)
Ins. Median: $322 (146% 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
Health Ohio Network $66 30%
Health Alliance Plan $69 - $93 31%
Aetna $82 - $769 37%
Blue Cross Blue Shield $89 - $375 40%
Frontpath $90 41%
Molina Healthcare Of Ohio $90 - $961 41%
Summacare $90 - $743 41%
Caresource $92 - $125 42%
UnitedHealthcare $99 45%
Medical Mutual Of Ohio $292 132%
Multiplan $292 132%
Cigna $442 200%
Buckeye Community Health Plan $461 209%
Amerihealth $625 283%
Humana $625 283%
Meridian Health Plan Of Mi $625 283%
Paramount Healthcare Inc $790 358%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 715 South Taft Avenue, Fremont, OH 43420
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals