CMS Price Transparency Data

Neurobehavioral status check

Facility: Cleveland Clinic

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $312
  • Cash Discount Price: $1,260
  • vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Cleveland Clinic is $312. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,260. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.41x the Medicare baseline. Located in 9500 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$1,260

Average discount available for prompt cash payment at this facility.

Insurance Median
$312

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: $1,260 (571%)
Insurance Median: $312 (141%)
Cash: $1,260 (571% of Medicare)
Ins. Median: $312 (141% 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
Summacare $49 - $924 22%
UnitedHealthcare $52 - $1,298 24%
Paramount $56 - $195 25%
Buckeye $57 - $198 26%
Caresource $57 - $189 26%
United $58 - $1,496 26%
Amerihealth $60 27%
Molina $60 - $198 27%
Cigna $72 - $1,516 33%
Aetna $75 - $1,938 34%
Blue Cross Blue Shield $75 - $1,646 34%
Devoted Health $75 - $289 34%
Humana $75 - $1,647 34%
The Health Plan $75 - $1,163 34%
Upmc $75 - $1,163 34%
Valor $75 - $289 34%
Communicare $79 - $303 36%
Perennial Health $81 - $312 37%
Pphp $81 - $318 37%
Zing Health $83 - $318 38%
Cc Ehp $143 - $1,209 65%
United Bh $153 - $234 69%
Oscar $179 - $745 81%
Ohcp $261 - $942 118%
Ohio Healthy $268 - $1,357 121%
Mmo $276 - $1,124 125%
Aultcare $288 - $950 131%
Amish Community Aid Plan $302 - $969 137%
Omas $335 - $969 152%
Healthsmart $368 - $1,066 167%
Phphi $402 - $1,163 182%
Clarity Health $436 - $1,260 198%
Gms $469 - $1,357 213%
Quality Care Partners $469 - $1,357 213%
Consociate Health $502 - $1,454 228%
Multiplan $603 - $1,744 273%
Three Rivers $603 - $1,744 273%
Usa Managed Care $603 273%
Php $1,163 527%
Medical Benefit Corp $1,357 615%
Parkview Health Plan $1,357 615%
Community Health Alliance $1,550 703%
Frontpath $1,744 791%
Managed Care Services $1,744 791%
Tertiary Care Network $1,744 791%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9500 Euclid Avenue, Cleveland, OH 44195
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals