CMS Price Transparency Data

Neurobehavioral status check

Facility: Hawkins County Memorial Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $206
  • Cash Discount Price: $128
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Hawkins County Memorial Hospital is $206. 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 0.93x the Medicare baseline. Located in 851 Locust Street, Rogersville, TN.
Cash / Self-Pay
$128

Average discount available for prompt cash payment at this facility.

Insurance Median
$206

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: $206 (93%)
Cash: $128 (58% of Medicare)
Ins. Median: $206 (93% 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 - $871 37%
Blue Cross Blue Shield $102 - $856 46%
Aetna $196 - $879 89%
Humana $196 89%
Managed Medicaire $196 89%
Medicare (plans) $196 89%
Sentara Health $196 - $221 89%
United Mine Workers Of America $196 89%
Amerigroup $204 92%
Cigna $206 - $397 93%
Devoted Health Plan $206 93%
Molina Healthcare $206 - $888 93%
Mountain Empire Pace $206 93%
Nhc Advantage $206 93%
Wellcare $208 - $856 94%
Medcost $407 184%
Ambetter / Centene $427 194%
First Health Coventry $770 349%
Seven Corners, Inc. $856 388%
Optima Health $872 395%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 851 Locust Street, Rogersville, TN 37857
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals