CMS Price Transparency Data

Neurobehavioral status check

Facility: Cleveland Clinic Children's Hospital for Rehab

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $443
Cash Discount Price: $480
vs. Medicare Baseline: 2.01x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Cleveland Clinic Children's Hospital for Rehab is $443. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $480. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 2.01x the Medicare baseline. Located in 2801 Martin Luther King, Jr Drive, Cleveland, OH.

Cash / Self-Pay

$480

Average discount available for prompt cash payment at this facility.

Insurance Median

$443

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: $480 (218%)

Insurance Median: $443 (201%)

Cash: $480 (218% of Medicare)

Ins. Median: $443 (201% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 201% of the Medicare baseline (a markup of 101%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Cigna	$125 - $319	57%
Oscar	$222 - $284	101%
UnitedHealthcare	$249 - $541	113%
Aultcare	$251	114%
Paramount	$270	122%
Blue Cross Blue Shield	$276 - $558	125%
Molina	$276	125%
Caresource	$281	127%
United	$281 - $424	127%
Amerihealth	$289	131%
Amish Community Aid Plan	$332 - $369	150%
Ohcp	$359	163%
Summacare	$366 - $370	166%
Buckeye	$403 - $489	183%
Healthsmart	$406	184%
Php	$443	201%
Phphi	$443	201%
The Health Plan	$443	201%
Upmc	$443	201%
Aetna	$474 - $738	215%
Gms	$517	234%
Medical Benefit Corp	$517	234%
Quality Care Partners	$517	234%
Cc Ehp	$523	237%
Consociate Health	$554	251%
Ohio Healthy	$590	267%
Managed Care Services	$664	301%
Multiplan	$664	301%
Three Rivers	$664	301%

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 $480.
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 Cleveland Clinic Children's Hospital for Rehab 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.