CMS Price Transparency Data

Neurobehavioral status check

Facility: Saint Thomas Highlands Hospital

Billing Code: 96116 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$238
about 1.1× the $221 Medicare rate · typically $160–$294
modeled estimate · not a bill or quote
What this hospital charges insurers
$294
Above the fair price
about $56 over the fair price · 1.3× Medicare
Medicare pays $221 Fair price $238 This hospital $294 Cash price $199 Hospital's list price $664

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

Highest price of the 9 TN hospitals we have prices for — worth calling around.

Cheapest $77 Priciest $294

Black dot = this hospital, among the 9 TN hospitals with a price for this procedure. Full list below.

A fair price for a Neurobehavioral status check is about $238 (about 1.1× the $221 Medicare rate). Saint Thomas Highlands Hospital charges insurers about $294, or about $199 in cash — above the fair price. Located in Sparta, TN.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $238. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $294 133%
Blue Cross Blue Shieldmajor $89 - $309 40%
Aetnamajor $78 - $300 35%
Humanamajor $294 133%
Ambetter (Centene) $382 173%
Amerigroup $294 133%
Cigna HealthSpring $294 133%
Oscar Health $412 187%
+ 6 smaller / regional plans $90 - $412
Government programs also on file: Medicare.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: 401 Sewell Dr, Sparta, TN 38583
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals