CMS Price Transparency Data

Neurobehavioral status check

Facility: Blount Memorial Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $309
Cash Discount Price: $148
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Blount Memorial Hospital is $309. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $148. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.40x the Medicare baseline. Located in 907 E Lamar Alexander Parkway, Maryville, TN.

Cash / Self-Pay

$148

Average discount available for prompt cash payment at this facility.

Insurance Median

$309

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: $148 (67%)

Insurance Median: $309 (140%)

Cash: $148 (67% of Medicare)

Ins. Median: $309 (140% 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
Medicaid / KanCare	$73 - $136	33%
UnitedHealthcare	$73 - $334	33%
Prisma Health Seniorcare Pace - Midlands [5400]	$110	50%
Prisma Health Seniorcare Pace-Upstate [5200]	$110	50%
Promise Health Plan Contracted [2401]	$167 - $286	76%
Orangeburg Senior Helping Center Pace [5401]	$190	86%
Cigna	$262 - $275	119%
Blue Cross Blue Shield	$267	121%
Mvp Health Care [3037]	$275	125%
Bob Jones Univ-Pai [821]	$286	130%
Preferred Administrators Contracted [2839]	$333	151%
Golden Rule Insurance Company [2991]	$334	151%
Oxford Health Plans [2992]	$334	151%
Medcost [2940]	$352 - $395	160%
Atlantic Packaging Contracted [4833]	$357	162%
Aps Healthcare System [2981]	$381	173%
Multiplan/Phcs Contracted [2950]	$424	192%
Aetna	$428	194%
Meritain Health Contracted [2200]	$428	194%
Nippon [2300]	$428	194%
Vsp Vision Care [2986]	$428	194%
First Health Contracted [2952]	$443	201%
Furman Int/Allen University Student [2951]	$443	201%
Quiktrip-First Health [3067]	$443	201%

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 $148.
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 Blount Memorial Hospital 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.