CMS Price Transparency Data

Neurobehavioral status check

Facility: Geisinger-Community Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $367
Cash Discount Price: $483
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Geisinger-Community Medical Center is $367. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $483. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.66x the Medicare baseline. Located in 1822 Mulberry Street, Scranton, PA.

Cash / Self-Pay

$483

Average discount available for prompt cash payment at this facility.

Insurance Median

$367

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: $483 (219%)

Insurance Median: $367 (166%)

Cash: $483 (219% of Medicare)

Ins. Median: $367 (166% 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
Blue Cross Blue Shield	$61 - $272	28%
Medicaid / KanCare	$69	31%
Geisinger Family Plan	$71	32%
Amerihealth	$79	36%
Upmc For You	$81	37%
Health Partners	$82	37%
Upmc Chip	$86	39%
Aetna	$308 - $460	140%
Geisinger Health Plan	$308 - $884	140%
Medicare (plans)	$308	140%
Prison Health Services	$308	140%
Humana	$314	142%
Cigna	$344	156%
Christian Healthcare Ministries	$390	177%
UnitedHealthcare	$430	195%
Healthnet	$456	207%
Universal Managed Care	$483 - $506	219%
Intergroup Services	$623 - $701	282%
Multiplan	$662	300%
Ambetter / Centene	$1,015	460%

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 $483.
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 Geisinger-Community 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.