CMS Price Transparency Data

Neurobehavioral status check

Facility: OHSU Hospital and Clinics

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $267
  • Cash Discount Price: $252
  • vs. Medicare Baseline: 1.21x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at OHSU Hospital and Clinics is $267. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $252. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.21x the Medicare baseline. Located in 3181 Sw Sam Jackson Park Road, Portland, OR.
Cash / Self-Pay
$252

Average discount available for prompt cash payment at this facility.

Insurance Median
$267

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: $252 (114%)
Insurance Median: $267 (121%)
Cash: $252 (114% of Medicare)
Ins. Median: $267 (121% 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
Community Health Plan Of Washington $74 - $339 34%
Care Oregon $194 - $286 88%
Intercommunity Health Network $194 88%
Kaiser Foundation Hospitals $194 - $388 88%
Medicare (plans) $194 - $388 88%
Pacific Source $194 - $302 88%
Samaritan Health Plan $213 - $606 97%
Moda $215 - $388 97%
Humana $242 - $257 110%
Trillium $242 110%
UnitedHealthcare $257 - $388 117%
Aetna $262 - $303 119%
Health Net Health Plan Of Oregon, Inc. $279 - $301 126%
Coventry First Health $291 132%
Providence Health Plan $291 - $330 132%
First Choice $294 133%
Cigna $355 161%
Blue Cross Blue Shield $388 176%
Molina Exchange $388 176%
Tuality Health $388 176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3181 Sw Sam Jackson Park Road, Portland, OR 97239
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals