CMS Price Transparency Data

Neurobehavioral status check

Facility: Leconte Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $221
  • Cash Discount Price: $69
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Leconte Medical Center is $221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.00x the Medicare baseline. Located in 742 Middlecreek Road, Sevierville, TN.
Cash / Self-Pay
$69

Average discount available for prompt cash payment at this facility.

Insurance Median
$221

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: $69 (31%)
Insurance Median: $221 (100%)
Cash: $69 (31% of Medicare)
Ins. Median: $221 (100% 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
Blue Cross Blue Shield $47 - $320 21%
Aetna $90 - $320 41%
Ehn $101 46%
UnitedHealthcare $112 - $320 51%
Cigna $114 - $320 52%
Ambetter / Centene $134 61%
Correctional Medical Services $134 61%
Community Services Network $146 66%
Usa Managed Care Organization $157 71%
Novanet $168 76%
Direct Care America $179 81%
Medsave Usa $179 81%
National Provider Network $179 81%
Beech Street $190 86%
Ccn Managed Care $190 86%
Initial Group $197 89%
Galaxy Health Network $202 92%
Wellpoint $240 - $320 109%
Farm Bureau $293 133%
Tricare $305 138%
Humana $314 142%
Devoted Health $320 145%
Wellcare $320 145%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 742 Middlecreek Road, Sevierville, TN 37862
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals