CMS Price Transparency Data

Neurobehavioral status check

Facility: Rainbow Babies and Childrens Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $289
  • Cash Discount Price: $323
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Rainbow Babies and Childrens Hospital is $289. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $323. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.31x the Medicare baseline. Located in 11100 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$323

Average discount available for prompt cash payment at this facility.

Insurance Median
$289

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: $323 (146%)
Insurance Median: $289 (131%)
Cash: $323 (146% of Medicare)
Ins. Median: $289 (131% 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 Of Ohio $144 - $342 65%
University Health Employee Plan (Contigo) $172 - $216 78%
Amish Aid Community Plan $216 98%
Amish Church Fund And Workers Aid Plan $216 98%
Buckeye Plain Ministries $216 98%
Christian Healthcare Ministries $216 98%
Sunrise Plain Communities $216 98%
Blue Cross Blue Shield $228 - $289 103%
Caresource $233 106%
Aetna $241 - $343 109%
Ambetter / Centene $241 109%
Cigna $241 - $289 109%
Jp Farley $241 - $259 109%
Immergrun $259 117%
UnitedHealthcare $266 - $303 121%
Aultcare $272 - $284 123%
Healthsmart $280 127%
Ohio Health Choice $280 - $388 127%
The Health Plan $280 - $302 127%
Devoted Health $289 131%
Health Ohio Network $289 131%
Humana $289 131%
Molina $289 131%
Primetime Health Plan $289 131%
Summacare $289 - $315 131%
Wellcare By Allwell $289 131%
Paramount $297 135%
Clarity $302 137%
Enterprise Group Planning $302 137%
Medical Mutual Traditional/Health Ohio $302 137%
Perennial Advantage Of Ohio $303 137%
Valor Health Plans $303 137%
Beech Street $345 - $388 156%
Ohio Preferred Network $345 - $388 156%
Century Health Network $366 166%
First Health $366 166%
Private Healthcare System $371 168%
Configurenet $388 176%
Fortified Provider Network $388 176%
Multiplan $388 176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11100 Euclid Avenue, Cleveland, OH 44106
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens