CMS Price Transparency Data

Neurobehavioral status check

Facility: Geisinger Wyoming Valley Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $350
  • Cash Discount Price: $483
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Geisinger Wyoming Valley Medical Center is $350. 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 1.59x the Medicare baseline. Located in 1000 East Mountain Boulevard, Wilkes Barre, PA.
Cash / Self-Pay
$483

Average discount available for prompt cash payment at this facility.

Insurance Median
$350

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: $350 (159%)
Cash: $483 (219% of Medicare)
Ins. Median: $350 (159% 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.

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
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%
Blue Cross Blue Shield $126 - $311 57%
Geisinger Health Plan $308 - $943 140%
Humana $308 140%
Life Geisinger $308 140%
Medicare (plans) $308 - $348 140%
Prison Health Services $308 140%
Cigna $337 - $353 153%
Aetna $363 - $520 165%
Christian Healthcare Ministries $390 177%
UnitedHealthcare $398 180%
Wyoming Seminary $545 247%
Intergroup Services $662 300%
Multiplan $662 300%
Ambetter / Centene $1,015 460%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 East Mountain Boulevard, Wilkes Barre, PA 18711
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals