CMS Price Transparency Data

Neurobehavioral status check

Facility: Fort Sanders Regional Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $216
  • Cash Discount Price: $69
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Fort Sanders Regional Medical Center is $216. 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 0.98x the Medicare baseline. Located in 1901 W Clinch Ave, Knoxville, TN.
Cash / Self-Pay
$69

Average discount available for prompt cash payment at this facility.

Insurance Median
$216

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: $216 (98%)
Cash: $69 (31% of Medicare)
Ins. Median: $216 (98% 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 - $299 21%
Aetna $90 - $299 41%
Ehn $101 46%
UnitedHealthcare $112 - $299 51%
Cigna $114 - $299 52%
Ambetter / Centene $134 61%
Correctional Medical Services $134 61%
Community Services Network $146 66%
Usa Managed Care Organization $157 71%
Beech Street $168 76%
Novanet $168 76%
Direct Care America $179 81%
Medsave Usa $179 81%
National Provider Network $179 81%
Ccn Managed Care $190 86%
Initial Group $197 89%
Galaxy Health Network $202 92%
Wellpoint $231 - $299 105%
Farm Bureau $274 124%
Tricare $284 129%
Humana $293 133%
Devoted Health $299 136%
Wellcare $299 136%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 W Clinch Ave, Knoxville, TN 37916
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals