CMS Price Transparency Data

Neurobehavioral status check

Facility: Geisinger Jersey Shore Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $353
  • Cash Discount Price: $474
  • vs. Medicare Baseline: 1.60x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Geisinger Jersey Shore Hospital is $353. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $474. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.60x the Medicare baseline. Located in 1020 Thompson Street, Jersey Shore, PA.
Cash / Self-Pay
$474

Average discount available for prompt cash payment at this facility.

Insurance Median
$353

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: $474 (215%)
Insurance Median: $353 (160%)
Cash: $474 (215% of Medicare)
Ins. Median: $353 (160% 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%
Amerihealth $76 34%
Geisinger Family Plan $76 34%
Upmc For You $81 37%
Health Partners $82 37%
Upmc Chip $86 39%
Blue Cross Blue Shield $123 - $454 56%
Advantra $125 57%
Aetna $125 - $585 57%
American Progressive $125 57%
Medicare (plans) $125 57%
Humana $126 57%
Geisinger Health Plan $153 - $376 69%
Ambetter / Centene $299 136%
UnitedHealthcare $340 154%
Cigna $367 166%
Prison Health Services $370 168%
Christian Healthcare Ministries $382 173%
Medical Development International $536 243%
Integrated Health Plan $574 260%
Prime Health Services $574 260%
Multiplan $612 277%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1020 Thompson Street, Jersey Shore, PA 17740
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals