CMS Price Transparency Data

Neurobehavioral status check

Facility: Ascension Seton Medical Center Austin

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $302
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.37x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Ascension Seton Medical Center Austin is $302. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.37x the Medicare baseline. Located in 1201 W 38Th St, Austin, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$302

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%)
Insurance Median: $302 (137%)
Ins. Median: $302 (137% 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
Champva $85 - $87 39%
Tricare $213 - $302 97%
Aarp Mc Wellmed $296 134%
Sendero Chap $299 136%
Addr Cancer Together $302 137%
Aetna $302 137%
Covid Hrsa $302 137%
Cshcn Cidc $302 137%
Devoted Health Mcr Replacement $302 137%
Humana $302 137%
Medicare (plans) $302 137%
Research Study $302 137%
Smarthealth $302 137%
Superior Allwell $302 137%
Uhcpcip $302 137%
Wellcare Med Advantage $302 137%
UnitedHealthcare $308 140%
Connected Senior Care $311 141%
Pphp Mcr Advantage $317 144%
Tx Independence Hp $317 144%
Occunet $422 191%
Sendero Idealcare $528 239%
Ambetter / Centene $543 246%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1201 W 38Th St, Austin, TX 78705
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals