CMS Price Transparency Data

Neurobehavioral status check

Facility: Franklin Woods Community 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 Franklin Woods Community 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 300 Med Tech Parkway, Johnson City, 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 $83 - $196 38%
Blue Cross Blue Shield $102 - $846 46%
Aetna $196 - $879 89%
Amerigroup $196 - $208 89%
First Health Coventry $196 89%
Humana $196 89%
Managed Medicaire $196 89%
Medicare (plans) $196 89%
Sentara Health $196 - $248 89%
United Mine Workers Of America $196 89%
Molina Healthcare $204 - $879 92%
Cigna $206 - $397 93%
Devoted Health Plan $206 93%
Nhc Advantage $206 93%
Wellcare $208 - $856 94%
Ambetter / Centene $427 194%
Medcost $728 330%
Optima Health $846 383%
Seven Corners, Inc. $856 388%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Med Tech Parkway, Johnson City, TN 37604
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals