CMS Price Transparency Data

Neurobehavioral status check

Facility: Baylor Scott & White Medical Center- Austin

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $385
Cash Discount Price: $459
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Baylor Scott & White Medical Center- Austin is $385. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $459. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.75x the Medicare baseline. Located in 5245 W Us 290, Austin, TX.

Cash / Self-Pay

$459

Average discount available for prompt cash payment at this facility.

Insurance Median

$385

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: $459 (208%)

Insurance Median: $385 (175%)

Cash: $459 (208% of Medicare)

Ins. Median: $385 (175% 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 Plan	$222 - $281	101%
Baylor Scott & White Health Plan	$267 - $463	121%
Humana	$281 - $536	127%
Triwest	$281	127%
American Health Plan	$295	134%
Healthspring	$295	134%
Procare Advantage	$295	134%
UnitedHealthcare	$323 - $529	146%
Blue Cross Blue Shield	$352 - $429	160%
Cigna	$364 - $424	165%
Aetna	$421	191%
Midcoast	$421	191%
Quiktrip	$421	191%
University Of Mary Hardin-Baylor	$444	201%
Curative	$498	226%
First Health	$536	243%
Private Health Care System	$574	260%

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 $459.
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 Baylor Scott & White Medical Center- Austin 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.