CMS Price Transparency Data

Neurobehavioral status check

Facility: Wellmont Holston Valley Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $215
  • Cash Discount Price: $128
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Wellmont Holston Valley Medical Center is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.97x the Medicare baseline. Located in 130 West Ravine Road, Kingsport, TN.
Cash / Self-Pay
$128

Average discount available for prompt cash payment at this facility.

Insurance Median
$215

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: $128 (58%)
Insurance Median: $215 (97%)
Cash: $128 (58% of Medicare)
Ins. Median: $215 (97% 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
UnitedHealthcare $81 - $769 37%
Blue Cross Blue Shield $102 - $792 46%
Aetna $205 - $800 93%
Humana $205 93%
Managed Medicaire $205 93%
Medicare (plans) $205 93%
Sentara Health $205 - $221 93%
United Mine Workers Of America $205 93%
Amerigroup $213 97%
Cigna $215 - $397 97%
Devoted Health Plan $215 97%
Molina Healthcare $215 - $808 97%
Mountain Empire Pace $215 97%
Nhc Advantage $215 97%
Wellcare $217 - $856 98%
Medcost $407 184%
Ambetter / Centene $447 203%
Seven Corners, Inc. $492 223%
First Health Coventry $659 299%
Optima Health $793 359%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 130 West Ravine Road, Kingsport, TN 37662
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals