Neurobehavioral status check
Facility: Hospital of Univ of Pennsylvania
Billing Code: 96116 (CPT)
- CPT Billing Code: 96116
- Insurance Median: $238
- Cash Discount Price: $335
- vs. Medicare Baseline: 1.08x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Ibc | $38 - $231 | 17% |
| Horizon Nj Health | $57 - $59 | 26% |
| Keystone Mercy Health Plan | $67 - $335 | 30% |
| Preferred Health Care Eliance | $74 | 34% |
| Aetna | $76 - $335 | 34% |
| Pgm - Regie De L'Assurance Maladie Quebec | $77 | 35% |
| Upmc | $84 - $335 | 38% |
| Blue Cross Blue Shield | $90 - $335 | 41% |
| Gspp And Wissahickon Hospice | $113 | 51% |
| Cigna | $116 - $309 | 53% |
| Pgm - Kuwait Defense | $117 - $151 | 53% |
| Qualcare | $127 | 58% |
| Olympus | $132 | 60% |
| Coventry | $134 - $171 | 61% |
| Medicaid / KanCare | $134 - $335 | 61% |
| Pgm - Chop | $134 | 61% |
| Wissahickon Hospice | $134 | 61% |
| UnitedHealthcare | $135 - $999 | 61% |
| Healthamerica/Coventry | $151 - $164 | 68% |
| First Health Global | $168 | 76% |
| Health Net | $201 - $335 | 91% |
| Kaiser Permanente | $201 - $335 | 91% |
| Pgm - Royal Embassy Of Saudi Arabia | $201 | 91% |
| Paired Kidney Exchange | $204 | 92% |
| Pgm - Embassy Of Qatar | $218 | 99% |
| Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) | $218 | 99% |
| Interlink | $224 | 102% |
| Medicare (plans) | $227 - $231 | 103% |
| Philadelphia Va Medical Center | $227 | 103% |
| Tricare | $227 | 103% |
| Geisinger Health Plan | $234 - $720 | 106% |
| Health Partners | $234 - $335 | 106% |
| Humana | $234 - $268 | 106% |
| Pgm - Embassy Of The United Emirates/Ipc | $234 | 106% |
| Devoted Health | $238 | 108% |
| Pa Health And Wellness | $238 - $374 | 108% |
| Penn Life (Living Independently For Elders) | $238 | 108% |
| Clover Health Plan | $245 | 111% |
| Keystone First | $252 | 114% |
| Us Family Health Plan | $261 | 118% |
| Health America/Ccn | $268 | 121% |
| Intergroup | $268 | 121% |
| Pgm - Kuwait Health Division | $268 | 121% |
| Pgm - Kuwait Oil | $268 | 121% |
| Preferred Care | $268 | 121% |
| Gateway Health Plan | $281 | 127% |
| Elap | $322 | 146% |
| Blue Quality Centers For Transplant (Bqct) | $335 | 152% |
| City Of Philadelphia Behavioral Health | $335 | 152% |
| Commercial Other | $335 | 152% |
| Ibc Commercial Hpn | $335 | 152% |
| International Pfs | $335 | 152% |
| Keystone Hmo Proactive | $335 | 152% |
| Pa Medical Assistance | $335 | 152% |
| United Behavioral Health | $335 | 152% |
| Workers Compensation | $335 | 152% |
| Claims Watcher | $363 - $409 | 165% |
| Oscar Health Plan | $386 | 175% |
| Centivo | $409 | 185% |
| Elap Services | $422 | 191% |
| Highmark | $477 | 216% |
| Penn Global Medicine | $601 | 272% |