CMS Price Transparency Data

Neurobehavioral status check

Facility: Highpoint Health-Sumner With Ascension Saint Thoma

Billing Code: 96116 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$185
about 0.8× the $221 Medicare rate · typically $80–$405
modeled estimate · not a bill or quote
What this hospital charges insurers
$400
Well above the fair price
about $215 over the fair price · 1.8× Medicare
Medicare pays $221 Fair price $185 This hospital $400 Cash price $335 Hospital's list price $1,448

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

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

Cheapest $77 Priciest $400

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

A fair price for a Neurobehavioral status check is about $185 (about 0.8× the $221 Medicare rate). Highpoint Health-Sumner With Ascension Saint Thoma charges insurers about $400, or about $335 in cash — well above the fair price. Located in Gallatin, TN.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $185. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare Blue Cross Blue ShieldAetnaCignaHumanaKaiser 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 $400 181%

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: 555 Hartsville Pike, Gallatin, TN 37066
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals