CMS Price Transparency Data

Neurobehavioral status check

Facility: Milton S Hershey Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $286
Cash Discount Price: $671
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Milton S Hershey Medical Center is $286. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $671. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.30x the Medicare baseline. Located in 500 University Drive, Hershey, PA.

Cash / Self-Pay

$671

Average discount available for prompt cash payment at this facility.

Insurance Median

$286

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: $671 (304%)

Insurance Median: $286 (130%)

Cash: $671 (304% of Medicare)

Ins. Median: $286 (130% 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
[Amerihealth Caritas]	$195 - $229	88%
[Highmark Wholecare]	$195 - $229	88%
[Geisinger]	$206 - $1,508	93%
[Health Partners Plans]	$213 - $234	97%
[Pa Health & Wellness]	$214 - $236	97%
[Highmark]	$227 - $1,231	103%
Aetna	$231 - $1,371	105%
Humana	$231	105%
[Healthspring]	$231	105%
UnitedHealthcare	$234 - $1,459	106%
[Upmc]	$234 - $1,495	106%
[Point Comfort Underwriters]	$286	130%
[Cbc]	$364 - $1,340	165%
[Highmark Aca]	$862	391%
[Highmark Choice Blue]	$985	447%
Cigna	$1,294	587%
[Preferred Healthcare Systems]	$1,518	688%
[First Health]	$1,619	734%
[Multiplan]	$1,619	734%

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 $671.
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 Milton S Hershey 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.