CMS Price Transparency Data

Neurobehavioral status check

Facility: Erlanger Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $128
  • Cash Discount Price: $107
  • vs. Medicare Baseline: 0.58x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Erlanger Medical Center is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.58x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.
Cash / Self-Pay
$107

Average discount available for prompt cash payment at this facility.

Insurance Median
$128

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: $107 (49%)
Insurance Median: $128 (58%)
Cash: $107 (49% of Medicare)
Ins. Median: $128 (58% 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 $77 - $300 35%
Humana $78 - $286 35%
Bluecare $86 - $297 39%
Amerigroup $91 - $237 41%
Caresource $91 - $571 41%
Cigna $91 - $551 41%
Peach State Hlth Plan $91 41%
Blue Cross Blue Shield $93 - $286 42%
Alexian $112 - $286 51%
Clover $112 - $286 51%
Medicare (plans) $112 51%
Upmc $112 - $286 51%
Aetna $113 - $294 51%
Bluecard - Network S $114 - $235 52%
Pruitthealth Premier $115 52%
American Health $116 - $294 53%
Bluecard - Network P $117 - $235 53%
Devoted Health $117 - $297 53%
Nhc $118 - $300 53%
Atrio Health $123 - $314 56%
Simpra Advantage $123 56%
Ambetter / Centene $140 - $357 63%
Caresource Ga $157 - $281 71%
Caresource Tn $157 - $281 71%
Olympus $168 - $191 76%
Alliant $180 82%
Caresource Nc $189 - $281 86%
Occunet $196 - $271 89%
Pnoa $196 - $714 89%
Point Comfort Underwriters $197 - $202 89%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 E 3Rd St, Chattanooga, TN 37403
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals