CMS Price Transparency Data

Neurobehavioral status check

Facility: Nationwide Children's Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $299
  • Cash Discount Price: $450
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Nationwide Children's Hospital is $299. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $450. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.36x the Medicare baseline. Located in 700 Children's Drive, Columbus, OH.
Cash / Self-Pay
$450

Average discount available for prompt cash payment at this facility.

Insurance Median
$299

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: $450 (204%)
Insurance Median: $299 (136%)
Cash: $450 (204% of Medicare)
Ins. Median: $299 (136% 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
Amerihealth $71 - $278 32%
Bchp $71 - $278 32%
Blue Cross Blue Shield $71 - $470 32%
Caresource $71 - $331 32%
Humana $71 - $475 32%
Molina $71 - $278 32%
UnitedHealthcare $71 - $475 32%
Tricare $82 37%
Ohio Ppo Connect $259 - $465 117%
Osu $259 - $465 117%
Aetna $270 - $475 122%
Mmo $287 - $470 130%
Cigna $298 - $470 135%
Front Path Health Coalition $298 - $470 135%
Ohc $298 - $465 135%
Ohg $298 - $450 135%
The Health Plan $298 - $480 135%
Ahpo $470 213%
Unicare $475 215%
Emerald Health $490 222%
First Health $490 222%
Phcs $490 222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 700 Children's Drive, Columbus, OH 43205
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens