CMS Price Transparency Data

Neurobehavioral status check

Facility: Lonesome Pine 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 $191–$360

modeled estimate · not a bill or quote

What this hospital charges insurers

$221

About the fair price

about $17 under the fair price · 1.0× Medicare

Medicare pays $221 Fair price $238 This hospital $221 Cash price $128 Hospital's list price $856

How we calculate the fair BaseRate →

How this hospital compares to other VA hospitals

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

Cheapest $87 Priciest $221

Black dot = this hospital, among the 9 VA 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). Lonesome Pine Hospital charges insurers about $221, or about $128 in cash — about the fair price. Located in Big Stone Gap, VA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$81 - $805	37%
Blue Cross Blue Shieldmajor	$102 - $856	46%
Aetnamajor	$211 - $813	96%
Cignamajor	$221 - $397	100%
Humanamajor	$211	96%
Ambetter (Centene)	$459	208%
Amerigroup	$211	96%
Devoted Health	$221	100%
Molina	$221 - $820	100%
Sentara	$211 - $805	96%
WellCare	$223	101%
+ 4 smaller / regional plans	$211 - $506

Government programs also on file: Medicare.

Excludes 2 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 128), 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 Lonesome Pine Hospital 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 Lonesome Pine Hospital

Compare: Neurobehavioral status check at other VA hospitals

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