Neurobehavioral status check
Facility: Pennsylvania Hospital
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 |
|---|---|---|
| Horizon Nj Health | $57 - $59 | 26% |
| Medicaid / KanCare | $60 - $335 | 27% |
| Keystone Mercy Health Plan | $67 | 30% |
| Pgm - Regie De L'Assurance Maladie Quebec | $77 | 35% |
| Upmc | $84 - $335 | 38% |
| Preferred Health Care Eliance | $87 | 39% |
| Blue Cross Blue Shield | $90 - $335 | 41% |
| Aetna | $93 - $335 | 42% |
| Cigna | $113 - $309 | 51% |
| Pgm - Kuwait Defense | $117 - $151 | 53% |
| Devon | $127 - $151 | 58% |
| Qualcare | $127 | 58% |
| Coventry | $134 - $171 | 61% |
| Pgm - Chop | $134 | 61% |
| Wissahickon Hospice | $134 | 61% |
| UnitedHealthcare | $135 - $999 | 61% |
| Healthamerica/Coventry | $151 - $164 | 68% |
| Olympus | $163 | 74% |
| First Health Global | $168 | 76% |
| Urn-Cancer Resource Services | $168 | 76% |
| Health Net | $201 - $335 | 91% |
| Pgm - Royal Embassy Of Saudi Arabia | $201 | 91% |
| Pgm - Embassy Of Qatar | $218 | 99% |
| Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) | $218 | 99% |
| Medicare (plans) | $226 - $230 | 102% |
| Philadelphia Va Medical Center | $226 | 102% |
| Tricare | $227 | 103% |
| Ibc | $230 | 104% |
| Geisinger Health Plan | $233 - $716 | 106% |
| Health Partners | $233 - $335 | 106% |
| Humana | $233 - $268 | 106% |
| Pgm - Embassy Of The United Emirates/Ipc | $234 | 106% |
| Pa Health And Wellness | $237 - $373 | 107% |
| Penn Life (Living Independently For Elders) | $237 | 107% |
| Clover Health Plan | $244 | 111% |
| Keystone First | $251 | 114% |
| Us Family Health Plan | $261 | 118% |
| Devon Health Services Inc | $268 | 121% |
| 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 | $280 | 127% |
| Elap | $321 | 146% |
| Commercial Other | $335 | 152% |
| Community Behavioral Health | $335 | 152% |
| Ibc Commercial Hpn | $335 | 152% |
| International Pfs | $335 | 152% |
| Keystone Hmo Proactive | $335 | 152% |
| Quest Behavioral Health | $335 | 152% |
| United Behavioral Health | $335 | 152% |
| Workers Compensation | $335 | 152% |
| Claims Watcher | $361 - $407 | 164% |
| Oscar Health Plan | $384 | 174% |
| Centivo | $407 | 184% |
| Elap Services | $420 | 190% |
| Highmark | $475 | 215% |
| Penn Global Medicine | $598 | 271% |