CMS Price Transparency Data

Neurobehavioral status check

Facility: Mid-Columbia Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $79
Cash Discount Price: $118
vs. Medicare Baseline: 0.36x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Mid-Columbia Medical Center is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.36x the Medicare baseline. Located in 1700 E 19Th Street, The Dalles, OR.

Cash / Self-Pay

$118

Average discount available for prompt cash payment at this facility.

Insurance Median

$79

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: $118 (53%)

Insurance Median: $79 (36%)

Cash: $118 (53% of Medicare)

Ins. Median: $79 (36% 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.

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
Providence Ppo - All Plans	$58	26%
Blue Cross Blue Shield	$72 - $153	33%
Community Hp Mcr Adv - All Plans	$72	33%
Molina Mcr Adv	$72	33%
Tricare	$72	33%
Va Ccn Triwest - All Plans	$72	33%
Healthnet Mcr Adv	$73	33%
Humana	$74	34%
Moda Mcr Adv	$74	34%
Devoted Mcr Adv - All Plans	$77	35%
Employee Health Plan - All Plans	$79	36%
Molina - All Other Plans	$79	36%
Healthnet - All Other Plans	$115	52%
Cigna	$120	54%
Multiplan/Phcs - All Plans	$122	55%
Molina Mcaid	$128	58%
Coventry - All Plans	$149	68%
First Choice - All Plans	$151	68%
Moda Health Plan - All Other Plans	$166	75%
Amerigroup Mcaid - All Plans	$246	112%
Coordinated Care Mcaid - All Plans	$246	112%
Aetna	$478	217%

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 $118.
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 Mid-Columbia Medical Center 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.