CMS Price Transparency Data

Neurobehavioral status check

Facility: St David's Medical Center

Billing Code: 96116 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$131

about 0.6× the $221 Medicare rate · typically $81–$428

modeled estimate · not a bill or quote

What this hospital charges insurers

$83

Below the fair price — a good deal

about $48 under the fair price · 0.4× Medicare

Medicare pays $221 Fair price $131 This hospital $83 Cash price $786 Hospital's list price $786

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

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

Cheapest $53 Priciest $83

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Neurobehavioral status check is about $131 (about 0.6× the $221 Medicare rate). St David's Medical Center charges insurers about $83, or about $786 in cash — below the fair price — a good deal. Located in Austin, TX.

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✓ Cigna HumanaKaiser 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	$196 - $354	89%
Blue Cross Blue Shieldmajor	$117 - $251	53%
Aetnamajor	$277 - $434	126%
Cignamajor	$252 - $322	114%
Amerigroup	$83	38%
Health Net	$511	232%
Healthcare Highways	$229 - $236	104%
Moda Health	$185 - $291	84%
Oscar Health	$151 - $168	68%
+ 19 smaller / regional plans	$226 - $707

Government programs also on file: Medicaid.

Excludes 6 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 786), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 96116.

Insurance Before you use insurance

Call your insurance company to confirm St David's Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 96116.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

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

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St David's Medical Center

Compare: Neurobehavioral status check at other TX hospitals

Insurance negotiated median for the same procedure, sorted lowest first.