CMS Price Transparency Data

Neurobehavioral status check

Facility: Johnson City Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $212
  • Cash Discount Price: $128
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Johnson City Medical Center is $212. 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 0.96x the Medicare baseline. Located in 400 N State of Franklin Rd, Johnson City, TN.
Cash / Self-Pay
$128

Average discount available for prompt cash payment at this facility.

Insurance Median
$212

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: $212 (96%)
Cash: $128 (58% of Medicare)
Ins. Median: $212 (96% 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 $83 - $803 38%
Blue Cross Blue Shield $102 - $803 46%
Aetna $201 - $810 91%
Amerigroup $201 - $236 91%
Humana $201 91%
Managed Medicaire $201 91%
Medicare (plans) $201 91%
Mountain Empire Pace $201 91%
Sentara Health $201 - $299 91%
United Mine Workers Of America $201 91%
Molina Healthcare $210 - $810 95%
Cigna $212 - $397 96%
Devoted Health Plan $212 96%
Nhc Advantage $212 96%
Wellcare $214 - $856 97%
Medcost $300 136%
Ambetter / Centene $439 199%
First Health Coventry $642 291%
Optima Health $779 353%
Seven Corners, Inc. $856 388%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N State of Franklin Rd, Johnson City, TN 37604
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals