CMS Price Transparency Data

Neurobehavioral status check

Facility: Methodist Hospital Atascosa

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $323
Cash Discount Price: $1,086
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Methodist Hospital Atascosa is $323. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,086. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.46x the Medicare baseline. Located in 1905 Hwy 97 East, Jourdanton, TX.

Cash / Self-Pay

$1,086

Average discount available for prompt cash payment at this facility.

Insurance Median

$323

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: $1,086 (492%)

Insurance Median: $323 (146%)

Cash: $1,086 (492% of Medicare)

Ins. Median: $323 (146% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Superior Health	$54	24%
Community First Health Plans	$130 - $293	59%
Imperial Insurance	$206	93%
Oscar	$217	98%
United	$267 - $489	121%
Aetna	$287 - $543	130%
Blue Cross Blue Shield	$314 - $471	142%
Cigna	$317 - $420	144%
Focus Health Solutions	$326	148%
Healthcare Highways	$334	151%
Valenz	$380	172%
Evry Health	$400	181%
Curative Administrators	$434	197%
First Health	$479	217%
Healthsmart Preferred Care	$597	271%
Multiplan	$814 - $923	369%
Triwest Health Alliance	$814	369%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,086.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Methodist Hospital Atascosa is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96116.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.