CMS Price Transparency Data

Neurobehavioral status check

Facility: Pennsylvania Hospital

Billing Code: 96116 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$287
about 1.3× the $221 Medicare rate · typically $133–$328
modeled estimate · not a bill or quote
What this hospital charges insurers
$294
About the fair price
about $7 over the fair price · 1.3× Medicare
Medicare pays $221 Fair price $287 This hospital $294 Cash price $335 Hospital's list price $335

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $71 Priciest $294

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a Neurobehavioral status check is about $287 (about 1.3× the $221 Medicare rate). Pennsylvania Hospital charges insurers about $294, or about $335 in cash — about the fair price. Located in Philadelphia, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $135 - $999 61%
Blue Cross Blue Shieldmajor $90 - $475 41%
Aetnamajor $93 - $335 42%
Cignamajor $113 - $309 51%
Humanamajor $233 - $268 106%
Clover Health $244 111%
Geisinger $233 - $716 106%
Health Net $201 - $335 91%
HealthPartners $233 - $335 106%
Oscar Health $384 174%
UPMC Health Plan $84 - $335 38%
+ 37 smaller / regional plans $57 - $598
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals